Manpower issues have been a hot topic for several years in the neurosurgical community, but, there is currently very little data about the market demands for practicing neurosurgeons. A report published in the Journal of the American Medical Association utilized the conference board help-wanted index to evaluate trends in physician marketplace demand. The JAMA study concluded that over the past five years there has been a significant fall in demand for specialist physicians. However, neurosurgery was not one of the field included in the JAMA study. By employing the same methodology as was used in the JAMA study to neurosurgery, the results challenge JAMA’s conclusion and show that, in fact, the neurosurgical market is actually quite stable.
The JAMA Study
The study conducted by Seifer et al in JAMA used the conference board help-wanted index as its methodology. This index tracks national changes in job availability by comparing changes in the number of help-wanted advertisements to a base figure.
In the study, Seifer et al used the Annals of Internal Medicine, American Family Physician, Pediatrics, Anesthesiology, Chest, the Journal of Bone and Joint Surgery and the New England of Journal of Medicine to analyze market trends in the appropriate medical generalist and specialty fields. The September of 1984 issue was used as the base year and the study compared the September issue of 1987, 1990, 1993 and 1995 to that base.
After analyzing the data, Seifer et al concluded that over the past five years there have been steep declines in the number of advertised positions for specialist physicians. In 1990, for example, there was a 4:1 ratio of specialist to generalist positions advertised, but, in 1995, this ratio dropped to 1:8. The most dramatic change was in medical specialists, where there was a 75 percent decline in the number of positions advertised between 1990 and 1995.
Orthopedic surgery was the only surgical subspecialty included in the study and saw a 50 percent decline.
Applying the Methodology to Neurosurgery
In order to apply this methodology to neurosurgery, data on the number of advertisements for positions was obtained from the Journal of Neurosurgery and Neurosurgery. From 1990 to 1995, there was only a 13 percent decline in the number of position advertisements. This is considerably less than the other specialties included in the JAMA study.
Conclusions
Using this methodology to analyze both specialists and generalists, neurosurgeons have reason for cautious optimism. The number of advertised positions in neurosurgery appears to be relatively stable compared to other specialists.
How accurately the conference board help-wanted index can be applied to professional medicine remains to be proven. However, in light of how little concrete information there is on marketplace trends in medicine, it does provide information that has logical reasoning behind it.