National Atlas of Surgeon Supply Across Specialty and Geographic Area.

BACKGROUND

National surgeon projections may obscure specialty- and community-level variation needed to target workforce and surgical access policies. We characterized surgeon supply, geographic distribution, and concentration across 12 surgical specialties and multiple geographic units.

STUDY

DESIGN

This national cross-sectional study identified surgeons with primary surgical taxonomy codes in the April 2025 National Plan and Provider Enumeration System. Surgeons practicing at multiple locations were weighted 0.6 to the primary site and 0.4 across secondary sites using 2024 North Carolina licensure data. Census data were used to calculate surgeon-to-population rates, and population-weighted Gini coefficients quantified concentration across 306 hospital referral regions. Federal facility files identified hospitals and ambulatory surgical centers in counties without surgeons.

RESULTS

Among 201,394 surgeons, 951 of 3,144 counties (30%), containing 9.6 million residents, had no identified surgeon; 1,180 (38%) had no general surgeon. Of 4,532 hospitals and 6,468 ambulatory surgical centers, 475 (4.3%), including 434 Critical Access Hospitals, were in counties without an identified surgeon. National supply was 59.2 surgeons per 100,000 population, but hospital referral region supply ranged from 20.8 to 250.4 per 100,000. Gini coefficients ranged from 0.150 for obstetrics and gynecology to 0.584 for transplant surgery, which was absent from 179 of 306 regions.

CONCLUSIONS

Surgeon availability varies substantially by specialty and geographic unit, and aggregate workforce counts may mask communities and healthcare facilities without locally identified surgeons. These data provide a national framework for geographically targeted workforce planning; future benchmarks should incorporate population need, surgical capability, and appropriate regionalization.