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Ann Thorac Surg 1987;44:450-461
© 1987 The Society of Thoracic Surgeons

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Articles

Thoracic Surgery Manpower: The Fourth Manpower Study of Thoracic Surgery: 1985 Report of the Ad Hoc Committee on Manpower of The American Association for Thoracic Surgery and The Society of Thoracic Surgeons

Floyd D. Loop, M.D.^*,,*, Benson R. Wilcox, M.D., Joseph N. Cunningham, Jr., M.D., Richard G. Fosburg, M.D., Alexander S. Geha, M.D., Hillel Laks, M.D., James B.D. Mark, M.D., Kavita Badhwar, M.A.^¶, George W. Williams, Ph.D.^¶

^* Chairman
Representing The Society of Thoracic Surgeons
Representing The American Association for Thoracic Surgery
^¶ From the Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Cleveland, OH

^* Address reprint requests to Dr. Loop, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106

Responding to a survey about their practice in 1985, 2,969 (70%) Board-certified thoracic surgeons provided data that were compared with data from manpower surveys in 1980 and 1976.

1976 1980 1985 Active respondents 2,240 2,394 2,657 Mean age (yr) 46 48 50 Number of major operations per week 1.8 2.4 2.9 Mean number of operations per surgeon 87 115 137  Cardiac 50 138 140  General thoracic 39 47 48  Peripheral vascular ... 56 47  Pacemaker ... 30 23 Cardiac operations as percentage of total 44 66 67 General thoracic operations as percentage of total 44 35 33

Thoracic surgeons were most active between ages 35 and 54 years when they accomplished 61% of all general thoracic and 85% of cardiac operations. Surgeons older than 50 years performed significantly more general thoracic operations than younger surgeons, and the younger group performed significantly more cardiac operations than their older counterparts.

Solo practice continued to decline. In smaller referral areas, the number of general thoracic procedures per surgeon increased, but the number of cardiac operations have decreased compared with 1980. Overall, general thoracic and cardiac operations increased, but peripheral vascular procedures and pacemaker insertions decreased in almost all nine census regions. Fewer general thoracic and cardiac operations were performed per thoracic surgeon in the western United States than in central and eastern regions.

In response to questions about work load, 55% believed that their clinical activity was satisfactory, 42% operated too little, and 3% operated too much. The 363 non-Thoracic Board-certified surgeons who responded performed 14% of general thoracic and 8% of cardiac surgery in 1985.

During the first half of the 1980s, our specialty certified an average of 134 thoracic surgeons annually, which is higher than the 120 surgeons per year estimated to meet the projected demand.

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