AATS: American Association for Thoracic Surgery.
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A Formidable Task: Population Analysis Predicts a Deficit of 2,000 Cardiothoracic Surgeons by 2030
Thomas E. Williams, Benjamin C. Sun, Patrick Ross, Andrew M. Thomas; Surgery, Ohio State University, Columbus, OH
READER COMMENTS
Objective: To estimate the cardiovascular workforce needed by 2030 to meet the needs of our population and to quantify its costs. Our field is changing. The volume of surgery and the nature of the surgery are changing. The nation’s population grew from 227,000,000 to 282,000,000 between 1980 and 2000, and by 2050 the population will be 420,000,000. At the same time, the applications for fellowship in our specialty are decreasing at an alarming rate. The ABTS has certified 4,500 CT surgeons since 1975, but only 1300 in the last ten years. The United States Department of Health and Human Services predicts only 3,620 full time CT surgeons in 2020.
Will we have enough cardiovascular and thoracic surgeons? While the volume of coronary revascularization surgery may or not increase, the volume of lung surgery will increase. Certainly the volume of heart failure surgery will increase - mitral valve repairs, ventricular restoration, and VAD’s.
Methods: Retrospective examination of the pertinent literature and with a modification Richard Cooper’s economic trend analysis, a population algorithm with a ratio of physicians to population of 1.42 /100,000. Each thoracic surgeon will practice thirty years from Board Certification to retirement. The Balanced Budget Act will not be revised; therefore we will certify 100 graduates from our programs per year. The assumed salaries will be $50,000 with benefits of 30%, and $ 15,000 of additional DME costs.
Results: The population in 2030 will be 364,000,000 with 5,169 CT surgeons needed at that time. Unfortunately, there will be only about 3,200 of them in practice with a shortage of almost 2,000. To maintain our current status per 100,000 population from 2011 to 2030, we will have to train 4,000 residents The total man years would be almost 28,000. The cost for this greater than $2,000,000,000. The annual cost for this training prorated over 20 years would be greater than $110,000,000.
Conclusion: 1. 1) We must train almost 4,000 surgeons in our specialty to meet the needs of the population by 2030, 2) That will cost almost $2,250,000,000, and 3) To do this, the Balanced Budget Act of 1997 must be revised to permit more residents to be trained in the United States.


POPULATION IN 2030 364,000,000
CARDIOTHORACIC SURGEONS NEEDED 5,169
CARDIOTHORACIC SURGEONS IN PRACTICE 3,175
SHORTAGE 1,994
ESTIMATED TO BE CERTIFIED 2011 TO 2030 2,000
CERTIFICATION GOAL 2011 TO 2030 3,994
RESIDENTS CERTIFIED EACH YEAR 200
TOTAL MAN YEARS AT 7 PER RESIDENT 27,958
DME COSTS AT \$80,000 PER YEAR OF RESIDENT TRAINING \$2,236,640,000
ANNUAL COSTS \$111,832,000

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