Geographic Disparities in the Adequacy of the Orthopaedic Surgery Workforce Relative to Other Musculoskeletal Medicine Specialties

INTRODUCTION: This study assessed geographic disparities in orthopaedic surgery workforce adequacy relative to other musculoskeletal medicine specialties. METHODS: This was a cross-sectional study of physicians in orthopaedic surgery, physical medicine and rehabilitation, and rheumatology using data from the Health Workforce Simulation Model. Supply was defined as the projected number of full-time equivalent physicians. Demand was defined as the number of full-time equivalent physicians required to meet United States healthcare needs under status quo and improved access scenarios. Adequacy was defined as the ratio of supply and demand. Trends were analyzed with linear regression and comparisons were made with chi squared tests. RESULTS: From 2024 to 2037, the supply of orthopaedic surgeons was projected to decrease from 32,310 to 30,620 (5.2% decrease, P < 0.001), whereas demand was projected to increase from 33,460 to 35,850 (7.1% increase, P < 0.001). As a result, orthopaedic surgery workforce adequacy was projected to decrease under status quo (96.6% to 85.4%, P < 0.001) and improved access (82.1% to 71.0%, P < 0.001) scenarios. Rheumatology workforce adequacy was projected to increase under status quo (87.0% to 89.5%, P < 0.001) and improved access (82.5% to 84.7%, P < 0.001) scenarios. No notable changes were projected for physical medicine and rehabilitation workforce adequacy under the status quo (91.2% to 92.8%, P = 0.059) and improved access (71.1% to 71.0%, P = 0.305) scenarios. Nonmetropolitan areas had markedly less workforce adequacy than metropolitan areas for all three specialties. In 2024, states with the lowest projected orthopaedic surgery workforce adequacy were West Virginia (60.9%), Arkansas (69.7%), and Alabama (74.1%). By 2037, states with the lowest projected orthopaedic surgery workforce adequacy will be Delaware West Virginia (54.5%), Arkansas (60.0%), and Delaware (61.5%). DISCUSSION: There are anticipated shortages in the orthopaedic surgery workforce, which are greatest in nonmetropolitan areas and certain identified states. Future work is needed to improve the adequacy of the orthopaedic surgery workforce in the Unitde States.