An Analysis of the Characteristics and Trends in Practicing Plastic Surgeons in California.

BACKGROUND: Studies suggest an increasing trend of plastic surgeons choosing private practice after training, with up to 90% pursuing private practice without future fellowships.1 Previous data showed that 66.7% of graduates from plastic surgery residency programs chose to pursue private practice without future fellowship, while more recent studies estimate this statistic has risen close to 90%.1,2 The literature has yet to characterize the current plastic surgery workforce and changes in its composition over time. This study aims to analyze the characteristics and training of plastic surgeons in California through a comparative study with general surgeons. METHODS: Surgeon demographics were extracted from the Centers for Medicare and Medicaid Services open database. Urban/rural classification and academic affiliation were crosslinked from the Inpatient Prospective System database and sole proprietorship status was cross-linked from the NPI Registry. Summary statistics and logistic regressions with chi-squared analysis were analyzed using STATA/MP17. RESULTS: Our analysis consisted of 3871 plastic and general surgeons in California. Compared to general surgeons, plastic surgeons were less likely to be females (P < 0.000), and more likely to be sole proprietors (P < 0.000), and affiliated with a teaching hospital (P < 0.005). There was no statistically significant difference in the percentage of rural-practicing plastic and general surgeons (P = 0.590). More recent plastic surgery graduates were more likely to be affiliated with an academic hospital (P < 0.0000). The composition of females significantly increased from the older graduated cohort to the most recent one. There was no significant difference in sole proprietorship and rural practice status between the oldest and youngest graduating cohorts. CONCLUSIONS: Although the California plastic surgery workforce is gaining female plastic surgeons and shifting to academic institutions, significant progress in serving rural communities is yet to be made. Our study suggests that there may be a shift in the trend of plastic surgeons opting for private practice, possibly driven by a desire for more stable positions in academia. Continued improvement in diversity and training of future plastic surgeons is needed to alleviate the rural care gap.

The 100 Most Cited Kluver-Bucy Research Articles: A Bibliometric Analysis.

Kluver-Bucy Syndrome (KBS) is a rare neuropsychiatric disorder characterized by hyperorality, hypersexuality, bulimia, visual agnosia, and amnesia due to lesions affecting bilateral temporal lobes. It is attributed to a multitude of causes, including stroke, herpes simplex encephalitis, Alzheimer's disease, and head trauma. Current treatments for KBS include symptomatic management with antipsychotics, mood stabilizers, carbamazepine, and selective serotonin reuptake inhibitors. The bibliometric analysis was done to reflect the relevance and understanding of KBS in recent literature. The SCOPUS database was utilized to conduct a search for all articles with the terms "Kluver-Bucy" and "Kluver Bucy" from January 1, 1955 (the first available articles from the search) to February 1, 2023. The parameters included in this analysis were article title, citation numbers, citations per year, authors, institutions, publishing journals, country of origin, Source Normalized Impact per Paper, and Scopus CiteScore. Since 1937, when Kluver-Bucy Syndrome was first defined, the publications on KBS have steadily increased, with up to six publications a year in 2002. The most common institutions were SUNY Upstate Medical University, VA Medical Center, and the State University of New York (SUNY) System. Seven of these papers were published in Neurology. Almost 75% of the articles were published in journals of medicine and neuroscience. This is the first bibliometric analysis to evaluate the most influential publications about Kluver-Bucy Syndrome. A majority of the research is case-based and there is a dearth of clinical trials to identify the exact pathophysiology and physiotherapy management, possibly owing to the rarity of the disease. Our research suggests that there may be a significant overlap between Sanfilippo syndrome and KBS, suggesting that refined guidelines for establishing diagnosis may be required for children. Our study could bring a renewed interest in this field and lead to additional research focused on understanding the pathophysiology of KBS in order to promote the development of novel diagnostics and treatment.