A critical, quantitative look at the future supply and demand of surgical specialists that may foretell rationing of surgical services. The Coming Shortage of Surgeons: Why They Are Disappearing and What That Means for Our Health is the only quantitative analysis of the workforce in orthopedic and thoracic surgery, otolaryngology, obstetrics and gynecology, general surgery, neurosurgery, and urology. It analyzes the demand and supply for these surgeons and gives the causes and remedies for these shortages. The Coming Shortage of Surgeons quantifies the demand for the surgical workforce, then examines the constraints to supply, which include soaring tuition and medical students' debts, the demand for a controllable or scheduled lifestyle, malpractice premium expenses, early retirement, and perhaps the most difficult hurdle to overcome: the provision in the Balanced Budget Act of 1997 that caps all medical and surgical residencies at 1996 levels.

The Future of the Nursing Workforce in the United States: Data, Trends and Implications provides a timely, comprehensive, and integrated body of data supported by rich discussion of the forces shaping the nursing workforce in the US. Using plain, jargon free language, the book identifies and describes the key changes in the current nursing workforce and provide insights about what is likely to develop in the future. The Future of the Nursing Workforce offers an in-depth discussion of specific policy options to help employers, educators, and policymakers design and implement actions aimed at strengthening the current and future RN workforce. The only book of its kind, this renowned author team presents extensive data, exhibits and tables on the nurse labor market, how the composition of the workforce is evolving, changes occurring in the work environment where nurses practice their profession, and on the publics opinion of the nursing profession.

Learning from the Wounded: The Civil War and the Rise of American Medical Science

A “lyrical, inspirational” story of doctors who changed the health care of an African nation (Tom Brokaw, author of The Greatest Generation) Dr. Dilan Ellegala arrives in Tanzania, shocked to find the entire country has just three brain surgeons for its population of forty-two million. Haydom Lutheran Hospital lacks even the most basic surgical tools, not even a saw to open a patient’s skull. Here, people with head injuries or brain tumors heal on their own or die. When confronted with a villager suffering from a severe head trauma, Dilan buys a tree saw from a farmer, sterilizes it, and then uses it to save the man’s life. Yet Dilan realizes that there are far too many neurosurgery patients for one person to save, and of course he will soon be leaving Tanzania. He needs to teach someone his skills. He identifies a potential student in Emmanuel Mayegga, a stubborn assistant medical officer who grew up in a mud hut. Though Mayegga has no medical degree, Dilan sees that Mayegga has the dexterity, intelligence, and determination to do brain surgery. Over six months, he teaches Mayegga how to remove tumors and treat hydrocephalus. And then, perhaps more important, Dilan teaches Mayegga how to pass on his newfound skills. Mayegga teaches a second Tanzanian, who teaches a third. It’s a case of teach-a-man-to-fish meets brain surgery. As he guides these Tanzanians to do things they never thought possible, Dilan challenges the Western medical establishment to do more than send vacationing doctors on short-term medical missions. He discovers solutions that could transform health care for two billion people across the world. A Surgeon in the Village is the incredible and riveting account of one man’s push to “train-forward”—to change our approach to aid and medical training before more lives are needlessly lost. His story is a testament to the transformational power of teaching and the ever-present potential for change. As many as seventeen million people die every year because of a shortage of surgeons, more than die from AIDS, malaria, and tuberculosis combined. Dilan Ellegala and other visionaries are boldly proposing ways of saving lives.

The American Society of Clinical Oncology (ASCO) predicts that by 2020, there will be an 81 percent increase in people living with or surviving cancer, but only a 14 percent increase in the number of practicing oncologists. As a result, there may be too few oncologists to meet the population's need for cancer care. To help address the challenges in overcoming this potential crisis of cancer care, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened the workshop Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century in Washington, DC on October 20 and 21, 2008.

Essential Surgery is part of a nine volume series for Disease Control Priorities which focuses on health interventions intended to reduce morbidity and mortality. The Essential Surgery volume focuses on four key aspects including global financial responsibility, emergency procedures, essential services organization and cost analysis.

In 2003, in the face of errors and accidents caused by medical and surgical trainees, the American Council of Graduate Medical Education mandated a reduction in resident work hours to eighty per week. Over the course of two and a half years spent observing residents and staff surgeons trying to implement this new regulation, Katherine C. Kellogg discovered that resistance to it was both strong and successful—in fact, two of the three hospitals she studied failed to make the change. Challenging Operations takes up the apparent paradox of medical professionals resisting reforms designed to help them and their patients. Through vivid anecdotes, interviews, and incisive observation and analysis, Kellogg shows the complex ways that institutional reforms spark resistance when they challenge long-standing beliefs, roles, and systems of authority. At a time when numerous policies have been enacted to address the nation’s soaring medical costs, uneven access to care, and shortage of primary-care physicians, Challenging Operations sheds new light on the difficulty of implementing reforms and offers concrete recommendations for effectively meeting that challenge.