Many rural hospitals are receiving notices or are anticipating retirement plans from their general surgeon(s). This has been expected, yet has been overshadowed by the struggle to recruit and keep primary care providers. All areas of the United States will suffer a shortage of general surgeons now and in the future, yet rural areas will bear the brunt of the shortage. There are many reasons for the problem but most focus on supply, demand, overspecialization of the specialty, and lifestyle factors. We must also consider the fact that in rural locales, other surgical specialties are not typically available to help meet demand. As an example, an urban-based physician may primarily practice as an ENT, yet be able to fill in the work schedule with other surgical options that cross over into what is typically general surgery domain in rural areas.







