Healthcare’s Achilles Heel: The Orthopaedic Surgeon Deficit 

At present, the world is facing a severe shortage of orthopaedic surgeons and specialists; in fact, this trend equally affects every healthcare system in the world. What is alarming is the increasing demand for orthopaedic care due to an aging population and a rise in musculoskeletal conditions. Additionally, the lack of sufficient specialists affects patient care causing people to wait an increasing amount of time to receive necessary treatments. It also places great stress on existing healthcare resources since hospitals and clinics are always under pressure to meet every patient’s needs, making staff overworked and contributing to the quality-of-care decline. Some of the insights from recent studies focus on improving education and training programs, implementing innovative healthcare delivery models, and leveraging technology to increase effectiveness, efficiency, and improved patient outcomes. This approach may only be viable with a comprehensive plan and latest research. 

Understanding the Scope of the Problem 

The demand for orthopaedic services continues to increase alongside an aging population and an increasing prevalence of musculoskeletal conditions. Currently, the United States has approximately 22,965 orthopaedic surgeons, with projections indicating a modest increase to 24,350 by 2025. However, the demand for orthopaedic services is expected to require 31,400 surgeons by that time, suggesting a potential shortfall of 7,050 orthopaedic surgeons. 

In Canada, the situation is no better. A national survey indicated that there was a deficit of orthopaedic surgeons and a lack of resources at the time which has only increased since. This was exacerbated by an increasing elderly population, which consequently increased the need for orthopaedic services. Moreover, as of 2023, Canada has 24% fewer nonphysician clinical staff per capita compared to the United States, contributing to these difficulties. Although the government has increased funding to address the surgical backlog, these efforts have largely been ineffective due to the ongoing healthcare worker shortage. 

Factors Contributing to the Shortage 

Several factors contribute to the shortage of orthopaedic surgeons. Of main importance is the long duration it takes to train orthopaedic fellowships. Though fellowships provide great advanced training, they also defer new surgeons from joining the workforce. This fact has been noted as a potential contributor to the shortage. 

Additionally, challenges faced by physicians in rural and underserved urban areas, such as increased call duties, more generalized practice, limited hospital resources, and lower physician reimbursement, further complicate the situation. 

Moreover, the lack of clinician-scientists in orthopaedics contributes to this deficit. One national survey found that greater recruitment of MD-PhD students into the field of orthopaedics would significantly boost the numbers of clinician-scientists during the next half-century. 

Strategies for Improvement 

Diverse Recruitment and Training: 

• Increasing the diversity of orthopaedic surgeons and focusing on underserved areas could mitigate the shortage. Studies have shown that students with global health experiences and community-based research backgrounds are more likely to practice in underserved areas. Additionally, efforts should be made to recruit more women and minorities into the field. 

Resource Allocation and Geographic Distribution: 

• Distributing orthopaedic surgeons equitably can help stem the deficit. This study showed that regions with fewer surgeons experience lower utilization of services, indicating a need for better resource allocation and strategic placement of surgeons to ensure equitable access to care. 

Enhanced Training Programs: 

• Training programs must use all available resources efficiently and thoughtfully. This can be achieved by enlisting enthusiastic educators and fostering collaboration between training programs and medical schools. Incorporating educational technology can also improve orthopaedic trainee education. 

Rural Recruitment Strategies: 

• Effective recruitment strategies can attract orthopaedic surgeons to rural areas. These strategies include loan repayment plans, competitive pay, supportive work environments, and personalizing the recruitment process to address the unique needs of potential candidates. 

The shortage of orthopaedic surgeons and specialists is a multi-dimensional issue that will require an all-encompassing approach. From strengthening training programs to resource allocation, diversifying recruitment efforts to include those historically excluded and marginalized, and implementing targeted rural recruitment strategies, we can begin to address this shortage and ensure better access to orthopaedic care for all populations. These are challenges not only of increasing the number of orthopaedic surgeons but also of building a sustainable and equitable system able to adjust to future healthcare demands.