This caught my attention last week: Shortage of General Surgeons Endangers Rural Americans by David Brown Washington Post, January 1, 2009. In Pocahontas County, like much of rural America, doctors are few and hospitals are far away, so of course, I read the article. Imagine my surprise to find that they chose to profile the general surgeon from my hometown, Creston, Iowa.
...Robert Kuhl has started his chores, too. The first is fixing the broken hip of a 94-year-old widow who fell the night before. Like so many of the 7,500 people in Creston, she would rather have the operation where she lives than in a big city miles away.
Through an incision in her thigh, Kuhl will saw off the broken end of the femur and replace it with a metal one that fits the joint socket. The procedure is called a hemiarthroplasty. Kuhl is the only person in an 80-mile radius who can do it. It will take him about 90 minutes.
I've never met Dr. Kuhl (I left the state for grad school about the time he started his practice in Creston.), but he replaced my mother's hip 16 years ago, and she made a remarkable recovery. A big part of it was treatment close to home, which, according to this article, is bound to become a scarcer commodity.
For the one-quarter of Americans who live outside metropolitan areas, general surgeons are the essential ingredient that keeps full-service medical care within reach. Without general surgeons as backup, family practitioners can't deliver babies, emergency rooms can't take trauma cases, and most internists won't do complicated procedures such as colonoscopies. But various forces -- educational, medical and sociological -- are making them an endangered species....More than half of rural general surgeons are older than 50, and a wave of retirements is expected in the coming decade.