Too many? Too few. New study reveals current trends in U. S. neurosurgical workforce

Remarkable changes in the neurosurgical specialty have taken place in the past 15 years. While advances in basic science have occurred and new technologies and therapies have proliferated, other, less propitious factors-such as the promises (some might say false promises) and hopes of managed care-heralded a period of downsizing in specialty care in the United States and an emergence of and emphasis on primary care. This downsizing of the neurosurgical specialty is demonstrated by a 2003 University of Utah study that compares the number of practicing U.S. neurosurgeons to the number of positions open to them. The study reveals a 12-year trend toward a shortage of neurosurgeons that has resulted in a distinct shortage of neurosurgeons currently. Based on the study results released herein, this article will explore the factors underlying the shortage of U.S. neurosurgeons and examine how the neurosurgical workforce must adapt to assure U.S. patients of appropriate neurosurgical care in the future.