Surgical rates in the United States: 1966 to 1978.

A dominant belief throughout the last half of the 1970s was that operative rates in the United States continued to show steady increases. This strongly suggested that an excessive number of operations were being performed. Unsubstantiated statements regarding surgical rates have been accepted at face value, and little critical analysis of the situation has occurred. This study utilizes data from the National Center for Health Statistics as the basis for an in-depth analysis of surgical rates in the United States from 1966 to 1978. All rates have been age-sex standardized. During the 13-year study period, operative rates increased by 26%. The major portion of that growth took place between 1966 and 1974. After that time, the rates leveled off and increased by only 2%. General surgery, gynecology, otorhinolaryngology, and urology have demonstrated decreasing rates of operation since 1974. Neurosurgery, ophthalmology, and cardiac surgery experienced sustained increases in growth during the study years. From 1966 through 1978 there was a steady growth in the total number of surgeons practicing within any given specialty. Through this study we were unable to document any correlation between the number of surgeons practicing a specialty and an increase in that specialty's surgical rates. The belief that operative rates will inevitably rise as the total number of surgeons increases is not supported by this report.