What question did this study set out to answer?

The aim is to explore access disparities in orthopaedic foot and ankle surgeons related to socioeconomic and geographic factors.

February 24, 2026

Uneven Ground: Exploring Socioeconomic and Geographic Differences in Access to Orthopaedic Foot and Ankle Surgeons in the United States

Puntos clave

The aim is to explore access disparities in orthopaedic foot and ankle surgeons related to socioeconomic and geographic factors.
Conducted a cross-sectional analysis of surgeon availability across various regions.
Sourced data from the American Academy of Orthopaedic Surgeons and analyzed socioeconomic metrics.
Contextualized trends based on insurance coverage, unemployment, poverty, and income levels.
Identified significant regional disparities in the availability of orthopaedic foot and ankle surgeons.
National average is 2.87 surgeons per million, with the northeast and midwest above this and south/west below.
Counties with at least one surgeon had higher median household incomes and lower poverty rates, both statistically significant.

Resumen

Purpose Across the United States, there is a well-documented projected shortage of orthopaedic surgeons, including those with foot and ankle subspecialty training. We sought to better understand the current state of patient access to orthopaedic foot and ankle surgeons across region, socioeconomic metrics, and rural areas. Methods In this cross-sectional analysis, foot and ankle surgeons identified through the American Academy of Orthopaedic Surgeons (AAOS) website were assigned a county, and distribution trends were contextualized by socioeconomic factors, including insurance coverage rates, unemployment rates, poverty rates, and median household income. Surgeon and location data were sourced from September 2024 to November 2024 via the AAOS “Find a Surgeon” directory, with Doximity and Google searches conducted in the event of partially empty profiles. Results Disparities in the presence and availability of orthopaedic foot and ankle surgeons by region were identified, with 4 states having only a single orthopaedic foot and ankle surgeon. While the national average of orthopaedic foot and ankle surgeons per million people was 2. 87, with the northeast and midwestern regions above this value, the southern and western regions were below the national average. Counties with at least one orthopaedic foot and ankle surgeon had greater median household incomes (77 459. 24 vs 60 682. 49; P <. 001) and lower poverty rates (11. 67% vs 14. 20%; P <. 001). Conclusions Inequality in the distribution of orthopaedic foot and ankle surgeons is prevalent at the regional, state, and county levels, as well as by rurality and household income/poverty status. Strategies that implement early exposure and/or focused mentorship for the subspeciality in medical school and/or residency can be combined with targeted programs for those interested in the field who wish to practice in underserved areas.

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