But more than a third of U.S. counties have no general surgeons, according to a new analysis published Sept. 28 in the Journal of the American College of Surgeons.
The study provides yet another data point that rural health care is in trouble in the U.S. It found that 38% of counties in the U.S.—home to roughly 15 million Americans—have no general surgeons, and 30% of counties have no surgeon across 12 different specialties. Even many rural counties with hospitals, which are often called critical access hospitals, have no full-time surgeon.
The lack of surgeons in rural areas could worsen as H.R. 1, also known as the One Big Beautiful Bill Act, is implemented across the country. It includes cuts to Medicaid and is projected to force many hospitals to close.
Part of the problem is that training isn’t keeping pace with demand, especially as the country ages and needs more medical procedures, Tsai says. In other research, the American College of Surgeons recently projected that the U.S. would face a shortage of nearly 28,000 surgeons by 2038.
Some other solutions could potentially help improve surgical care in rural areas. Doctors in other countries are experimenting with doing robotic surgeries through telehealth, for instance, but regulatory barriers in the U.S. have prevented that here, he says. By comparison, rural areas can access primary care relatively easily, he says, through telehealth and advanced practice providers. What they often can’t access, he says, is specialty care like surgery.
“As the population ages and patients have more and more complex conditions, what they will need increasingly is actual access to surgeons and surgical specialists to address their surgical issues,” he says.
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