A comprehensive analysis of surgical procedures in rural surgery practices

Am J Surg. 2010 Dec;200(6):820-5; discussion 825-6. doi: 10.1016/j.amjsurg.2010.07.029.


Background: Data regarding the practice patterns of surgeons are derived from indirect information and may not reflect practice patterns in rural surgery. The aim of this study was to analyze all procedures performed by rural surgeons in North Dakota and South Dakota in 2006.

Methods: All surgeons in the Dakotas were identified by state American College of Surgeons databases. Rural urban commuting area codes were used to identify rural surgeons. Current Procedural Terminology codes from clinic, outpatient, and inpatient procedures performed during 2006 were obtained.

Results: Data were obtained from 81% of rural surgeons. A total of 46,052 Current Procedural Terminology procedure codes were analyzed. Rural surgeons averaged 1,071 procedures/year, composed of 25.6% general surgery, 39.8% endoscopy, 17.9% minor surgery, and 12.3% surgical specialty procedures. Surgeons in small and large rural communities differed in total procedures per year (1,346 vs 988). Significant differences existed in the types of procedures performed by surgeons in large and small rural communities (P < .001).

Conclusions: Rural surgeons perform a high volume of procedures, with endoscopic and minor surgical procedures comprising over 55% of their practices. Understanding rural surgeons' caseload will help guide the training of rural surgeons.

MeSH terms

  • Humans
  • North Dakota
  • Practice Patterns, Physicians'*
  • Rural Health Services / statistics & numerical data*
  • South Dakota
  • Surgical Procedures, Operative / statistics & numerical data*