RESUMO
INTRODUCTION: There are many reasons why orthopaedic surgeons move or change careers. We asked the questions: (1) What is the geographic distribution of orthopaedic surgeons with respect to age, sex, and race and ethnicity? (2) How has our workforce changed over time with regard to these factors? (3) Are there any patterns or trends detected regarding policy or regulatory events that coincide with these differences? METHODS: The American Academy of Orthopaedic Surgeons surveys over 30,000 members, collecting data on demographics, age, race sex, and practice statistics. We calculated geographic distributions and evaluated these differences over time-potential influences from malpractice suits or tort reform were investigated. RESULTS: Overall surgeon density increased over time. The largest negative changes were noted in District of Columbia, Wyoming, and North Dakota and positive changes in Colorado, South Dakota, and West Virginia. Age across all states increased (mean 1.7 years). Number of female surgeons increased in most states (4.6% to 5.7%). Number of African Americans increased from 1.6% to 1.8%, Hispanic/LatinX from 1.8% to 2.2%, Asian from 5.5% to 6.7%, and multiracial from 0.8% to 1.2%. No change was noted in the percentage of Native American surgeons. DISCUSSION: Surgeon density increased from 2012 to 2018; the cause for this change was not evident. Small increases in surgeon population, female surgeons, and in some underrepresented minorities were seen.
Assuntos
Cirurgiões Ortopédicos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Etnicidade/estatística & dados numéricos , Mão de Obra em Saúde/estatística & dados numéricos , Mão de Obra em Saúde/tendências , Cirurgiões Ortopédicos/estatística & dados numéricos , Ortopedia , Inquéritos e Questionários , Estados Unidos , Recursos Humanos , Diversidade de Recursos Humanos , Negro ou Afro-Americano , Hispânico ou Latino , Asiático , Grupos Raciais , Indígena Americano ou Nativo do AlascaRESUMO
Cost-utility analysis using a Markov decision model finds that platelet-rich plasma (PRP) is not cost-effective in rotator cuff repair because of no added outcomes benefit or improvement in retear rate according to best current evidence (Level I to III studies). To achieve the willingness-to-pay threshold, PRP would need to reduce rotator cuff retear rates. The authors have opened dialogue for us to determine what is the value and what should be the cost for PRP when it comes to rotator cuff repair.