The migration of surgeons.

This study attempted to determine if there were identifiable trends in where surgeons moved from and to over time. Physicians, including surgeons, change the location of their practices over their careers. If this movement follows economic theory that surgeons, like most professionals, seek better economic opportunities, then their movements should be toward better markets for their services. Using US national data (American Medical Association Masterfile) that describes the practice locations of surgeons, this study tracked county-level changes of practice location and summarized the characteristics of the places surgeons left and those they moved to. The analysis was primarily descriptive with linear multivariate regression models constructed to determine the characteristics of the surgeons who moved and of the places from and to which they moved. Approximately 30,262 (32.1%) of 94,630 actively practicing, post-training, nonfederal surgeons moved in the 10-year period 1996-2006. The overall tendency of movers was to go to places that had more physicians and a better overall economic environment. These trends, if they continue, may create pressure on access in rural and urban underserved areas.