UW researchers found that the number of general surgeons per 100,000 Americans has declined during the past two decades.

Results published in last month’s Archives of Surgery show a 25 percent decline in the overall number of general surgeons per 100,000 people between 1981 and 2005. In addition, 46 percent of general surgeons are between the ages of 50 and 62. As the surgeons retire, fear of an impending shortage of general surgeons raises concerns for the aging baby boomer population.

“Now you have the baby boomers moving into the more elderly years, the demand for general surgery goes up,” said Dana Lynge, co-author of the study. “The question is: will there be enough general surgeons around for larger, more elderly populations?”

General surgeons are typically responsible for trauma victims and critically ill patients. Their surgical skills range from appendix removal to treatment of car crash victims.

General surgeons make much less money than specialty surgeons. With Medicare and Medicaid limitations, high price of malpractice insurance and medical school debts to pay off, many are shying away from less lucrative careers.

According to the Association of American Medical Colleges, the average medical school debt is $139,517 for the graduating class of 2007. It increased almost 7 percent from the previous year.

The demanding lifestyle of general surgeons is also a deterrent.

“Fewer people are attracted to getting called in the middle of the night taking care of emergencies,” said Lisa Garrison, a fourth year medical student who will do her surgical residency at Virginia Mason in June. “Everything falls on you. It’s going to be more work for less money. Medical school students want a balance between work and life.”

The results also suggest that rural populations may be hit harder by the shrinking supply of general surgeons.

“In the rural areas, the impact would be bigger because you lose trauma coverage, and general surgeons provide most of the trauma education and coordination,” Lynge said. “[Rural general surgeons] are facing problems with recruiting new partners because many of the current new graduates are not willing to seek that life.”

On top of being geographically isolated, practicing general surgery in a rural setting would mean a heavier caseload and more frequent calls. That kind of lifestyle is not appealing to most medical school graduates.

“The problem is that you’re possibly only one or two general surgeons in the area, and you have to be on call constantly,” said Kelly Kempe, fourth year UW medical student, who will start general surgery residency in June at Louisiana State University. “It can be so demanding but also very rewarding. It’s hard to be good at everything you do.”

Measures are underway to address this looming shortage.

Lynge said that hospitals are starting to hire “hospitalists,” surgeons who take care of surgical emergencies throughout the day. They work for the hospital rather than have an independent standing practice.