Surgical operations in the United States: 1979 to 1984

With data from the National Center for Health Statistics, an in-depth analysis of the number of surgical operations performed in the United States from 1979 to 1984 was carried out. During the study period, there was a 9% increase in the total number of surgical procedures. For the same time period, the number of surgeons grew 20%. By 1984 general surgical operations were greatest in number. However, the 5-year increase in the number of general surgical operations was just 7%. Although obstetric and gynecologic operations declined 1%, the most common inpatient surgical operation performed in the United States is cesarean section. Orthopedic surgical operations grew 24% and arthroscopy has become this country's sixteenth most frequent operation. Cataract extraction is the fourth most common operation and represents 60% of all ophthalmologic surgery. Cardiothoracic operations had the largest increase, 34%. This study demonstrates the dynamics of surgical practice in the United States and conveys a dual message. There is reassuring news concerning "unnecessary" surgery due to supplier-induced demand for operations. Despite recent large increases in the number of surgeons, there have not been parallel increases in the number of surgical operations. The belief that more surgeons necessarily means more surgery is not noted. The disturbing news concerns surgical case loads. The prospect of more surgeons performing fewer operations has become a major problem. The surgical community will have to address this growing inbalance.