The Difference Between Need and Want: The Surgeon Shortage in Rural America

Guest Blogger

Wyoming is the 10th largest state geographically in the United States, as well as the least populous, with only 525,000 people dispersed across 98,000 square miles. Right now, we have only 25 surgeons serving Wyoming residents, leaving nine of our 23 counties without a surgeon.

My organization is in the business of recruiting physicians to Wyoming – and retaining them. It is not an easy job. For example, in the past three years, Wyoming Health Resources Network has posted 12 openings for general surgery; unfortunately, six of these still remain open.

The nature of rural medicine is that communities share services: a surgeon may have a “home base” but satellite out to other communities where it isn’t viable to maintain a surgeon. Professionally, I understand this very well, but in the past few years, I’ve also had some personal experiences as a consequence of the surgeon shortage. In one instance, my son required gall bladder surgery but he lived in a small community which was served by a surgeon from another town who saw patients in surrounding areas as his schedule allowed. After waiting weeks, missing day after day of work due to pain and making many phone calls, my son finally located a hospital with a surgeon on staff that could perform the surgery.

Another family member was scheduled for a Caesarean and a routine hernia operation simultaneously. Her baby came early due to complications, and there was no surgeon on staff to complete the hernia procedure at the time. So what could have been done in a single hospital visit became two trips to the hospital, two separate procedures, two set of expenses, two bouts of recovery, etc. My experiences are not unique – the lack of access to quality surgical care is a reality for many rural communities like mine.

Wyoming understands the difference between “need” and “want.” Every community may want a surgeon, but the reality is many small communities cannot support a full time surgeon. Sharing surgeons between communities is a model that works. But what do we do when there aren’t enough surgeons to share the burden?

Recently, I attended the National Rural Health Association’s annual conference in Miami Beach, Fla., which brought together people from across the country to talk about how health care will look in the future for the 62 million American’s living in rural communities.

Everyone agreed that recruiting to rural areas can be a challenge. Tim Skinner, executive director of the National Rural Recruitment and Retention Network (3RNET) gave a presentation at this meeting on the surgeon shortage. He made two key points: we need more training programs for general surgeons; and programs need to focus on rural populations. He also stated that future planning needs to become the norm. A rural site will need to plan at least two years ahead when searching for a surgeon.

For now, Wyoming is pulling together as a state to ensure the health care needs of its citizens are met. Times are changing, health care is changing, but in the end – access to health care affects all of us. Together we need to present a unified message of need, build relationships to encourage early interest in health care professions, nurture the surgeons we have, and create a welcoming environment for new surgeons.

Pennie Hunt
Executive Director, Wyoming Health Resources Network