Abstract
, among other lay presentations.It is commonly assumed that this is a small town or ruralissue.Ourhypothesis,however,isthatthisisamuchmorewidely distributed problem that affects all of mid-Americabetween the Allegheny and the Rocky Mountains, and insomepartsofbothcoasts.Arapidlyburgeoningamountofliterature, which is referenced in this article, and describesthis “surgeon shortage,” has been developing in both layand professional texts. This shortage has been difficult toquantifynationallyandlocally;consensusfiguresshowthat7.68 general surgeons per 100,000 population in 1981dropped to 5.69 in 2005. Interestingly, in the same timeperiod, the urban surgeon ratio fell 27%, and the ruralsurgeon ratio fell 21%.
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