Exploring surgical attrition in the United States

Investigators examined changes in the rate of attrition among surgeons and different surgical specialties, including oral and maxillofacial surgery.

In a retrospective longitudinal cohort study published in the Journal of the American College of Surgeons, investigators used data from the 2013 to 2023 Medicare Physician and Other Practitioners Public Use Files and National Plan and Provider Enumeration System to identify attrition rates across 19 surgical specialties.

The investigators found a cumulative attrition rate of just under 10% over a median period of eight years. The annual attrition rate remained steady at about 1.5% between 2013 and 2018 before rising to 2.5% in 2019 and dropping just below 1.5% in 2020.

The five-year cumulative rate of attrition was highest among oral and maxillofacial surgeons (25.1%) followed by obstetric and gynecologic surgeons (23.2%) and plastic surgeons (19.3%). Oral and maxillofacial surgeons and obstetric and gynecologic surgeons also exhibited the highest risks of attrition.

Because of the high rate of attrition across the surgical field, the investigators urged for the development of strategies to maintain the surgical workforce in the United States.

Read more: Journal of the American College of Surgeons

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