The general surgeon shortage: causes, consequences, and solutions.

In recent years, there has been great interest in the looming shortage of general surgeons. The media has begun to take notice, and politicians are now being forced to answer difficult questions regarding access to emergent surgical care. There are a number of issues which have impacted upon the shortage: physician workforce shortages secondary to the population boom and the inadequate response of medical school enrollment; changes in the mentality of current medical graduates desiring a more "balanced lifestyle" and its impact on specialty selection; subspecialization; the malpractice crisis; and declining reimbursements for surgical procedures. This review examines these issues in depth and suggests several potential solutions to the problem, including the surgical hospitalist model; the integration of trauma with emergency surgery; and tort and legislative reform. Further discussion centers around the responsibilities of both the "system" and the individual general surgeon in dealing with this important crisis.