Over 15 Million Americans Lack Access to General Surgeons in Their Counties

A recent comprehensive study published in the Journal of the American College of Surgeons outlines a concerning trend: more than 15 million Americans reside in one of the 1,180 counties across the United States that lacks a general surgeon. This revelation, unveiled during the ACS Clinical Congress 2026 in Washington, D.C., marks the first time the supply of surgeons has been systematically analyzed across 12 surgical specialties on a county-by-county basis. The study not only emphasizes the shortage of surgical specialists but also highlights a broader issue of access to essential healthcare services, particularly in rural regions.

Study Insights

The study, conducted jointly by the American College of Surgeons (ACS) and the UNC Cecil G. Sheps Center for Health Services Research, utilizes an innovative ACS Surgical Workforce Mapping Tool. This tool provides an interactive visualization of surgical workforce data across all 3,144 U.S. counties, revealing critical gaps in access to surgical care. Of the total counties analyzed, 951 were found to have no surgeon in any of the identified specialties, which collectively serve approximately 9.6 million people. Additionally, rural critical access hospitals, which often serve as the backbone of emergency and inpatient care in these communities, are particularly impacted, with 434 such facilities situated in counties devoid of any full-time surgeon.

Every one of the 306 hospital referral regions across the country has at least one general surgeon, but the scatter in surgeon distribution complicates access for patients living in rural areas. This stark contrast accentuates the challenges faced by individuals requiring surgical interventions, as they may be forced to travel significant distances to receive care, thus diminishing timely access to potentially life-saving procedures.

Surgeons and Specialties Distribution

The new analysis identifies 201,394 surgeons practicing in the U.S., translating to 59.2 surgeons per 100,000 people overall. However, this statistic masks substantial regional variances in surgeon supply, with ratios ranging dramatically from only 20.8 surgeons per 100,000 people in areas such as Harlingen, Texas, to a striking 250.4 in Rochester, Minnesota. Moreover, access to surgical specialties varies widely: for instance, transplant surgery practitioners are largely concentrated, with some regions experiencing an absence of such specialists altogether.

Implications for Rural Communities

For rural communities, the absence of general surgeons poses substantial healthcare risks. As part of the study, researchers identified that 475 hospitals and surgical facilities are located in counties with no full-time surgeon, underscoring the vulnerabilities these communities face.

Dr. Erin P. Fraher, who led the study, states that the ACS Surgical Workforce Mapping Tool equips policymakers, health systems, and communities to grasp their local surgical landscapes better and identify areas needing improvement in healthcare accessibility. The tool’s ability to allow users to filter data by specialty and geographic region facilitates targeted interventions for underserved populations.

Call to Action

The findings of this study are timely, particularly in light of the Ensuring Access to General Surgery Act of 2026 (H.R. 7198), which aims to develop methodologies for identifying areas with a shortage of general surgical services. The American College of Surgeons is urging efforts to enhance awareness of these disparities to advocate for necessary investments in surgical training, particularly in areas facing acute shortages of healthcare professionals. "Mapping the surgical workforce is the first critical step toward crafting strategic responses to these disparities," notes Dr. Patricia L. Turner, Executive Director of ACS.

As the health sector grapples with the fallout from the pandemic, understanding and addressing these disparities in surgeon availability is crucial for advancing the quality of care and outcomes for all patients across the United States.

For more details, access the ACS Surgical Workforce Mapping Tool for a thorough examination of the surgeon supply landscape and regional healthcare needs.