Welcome to the American College of Surgeons Health Policy Research Institute Website

The American College of Surgeons Health Policy Research Institute is an organization which studies and reports on issues related to the state of the surgical profession, the surgical workforce, and surgical utilization in the United States.  The Institute provides expert advice, data analysis, and original research for surgical professional associations and boards, policymakers, and the health services research community. 


December 2012: We have posted new new maps showing supply and change in supply of surgical subspecialist groups between 2006-2011.

October 2012:The US Atlas of the Surgical Workforce was updated with 2011 data on surgeons and physicians.

September 2012: Erin Fraher, Andy Knapton, George Sheldon, Anthony Meyer and Thomas Ricketts published Projecting Surgeon Supply Using a Dynamic Model in Annals of Surgery (available September 27, 2012, ahead of print).

July 2012: We have posted three series of new maps showing total and general surgeon supply and change in supply between 2006-2011.

May 2012: Dr. Thomas C. Ricketts, Dr. Erin Fraher and several doctoral students from UNC Chapel Hill visited Lord Bernard Ribeiro on May 22-23. There, they learned about Parliament's efforts to reform the English health and social care system, and made comparisons to ongoing health reform efforts in the US.

May 2012: Dr. Erin Fraher was invited to present to the Council of Medical Specialty Societies at the GME Financing Conference on May 10, 2012. She provided an overview of a project designed to answer the question, "What changes are needed to better align GME policy to meet the surgical health needs of the US population?" This project is slated to be completed in Spring 2013. Access the slides here.

March 2012: HPRI data tracks: Trends in the otolaryngology workforce in the U.S.. Bulletin of the American College of Surgeons.

January 2012: HPRI data tracks: Urology workforce trends. Bulletin of the American College of Surgeons.

March 2012: Dr. Thomas C. Ricketts and Dan Belsky published Medicare Costs and Surgeon Supply in Hospital Service Areas in the March 2012 issue of Annals of Surgery.

November 2011: HPRI data tracks: Burn care: Are there sufficient providers and facilities? Bulletin of the American College of Surgeons.

October 2011: Drs. George Sheldon, Anthony Charles, Karyn Stitzenberg and Thomas Ricketts presented on panels at the American College of Surgeons Clinical Congress in San Francisco. Dr. Sheldon moderated a panel on the Patient Protection and Affordable Care Act as well as presenting a paper on GME and health reform. Dr. Ricketts presented on "Secular Trends Trump Health Reform" on the panel that also included Dr. Donald Detmer and Dr. Andrew Warshaw. Drs. Stitzenberg and Charles were part of a panel on Surgery and Inequality, the theme of the overall meeting.

September 2011: The US Atlas of the Surgical Workforce was updated to include additional surgical subspecialties, as well as demographic and health access indicators. The next update will be available in Summer 2012.

September 2011: HPRI data tracks: Geographic distribution of general surgeons: Comparisons across time and specialties. Bulletin of the American College of Surgeons.

July 2011: Dr. Brad Wright and Dr. John Scarborough published Characterizing and Fostering Charity Care in the Surgeon Workforce in the July 2011 issue of Annals of Surgery.

Burn care: Are there sufficient providers and facilities? Approximately 450,000 burn injuries receive medical treatment each year, and roughly 3,500 people die in fire-related accidents each year. Burn center care, similar to medical services delivered at trauma centers, has been associated with improved survival, decreased hospital costs, and shorter lengths of hospital stay. This article briefly describes the number and distribution of burn centers in the U.S., and provides an explanation of the verification and referral process for burn centers.


The Surgery Workforce Atlas is an interactive system that shows, county-by-county and state-by state, where shortages of surgeons and other physicians threaten patient access to timely, safe, high-quality, and affordable care.

The Geographic Distribution of General Surgeons: Comparisons across Time and Specialties Policymakers and researchers continue to debate whether there is an overall shortage of surgeons, a maldistribution, or both. The recurring question, "How many surgeons do we need?" has not been definitively answered. There are specific surgeon-to-population ratios that are considered benchmarks for this issue, but they offer little guidance on what constitutes a shortage. In this article, the Gini index—a tool for assessing the overall fairness of the distribution of surgeons—is presented, along with guidance for how it may be useful in monitoring geographic access to surgical services.

Developing an Index for Surgical Underservice Findings from this fact sheet highlight areas that may not have the resources to support surgery. Based on existing Hospital Services Areas, the fact sheet proposes a threshold for a critical shortage area for general surgeons (3.0 per 100,000 population) and maps the US Hospital Service Areas (HSAs) that have a critical shortage of general surgeons. The analysis in this fact sheet also shows that the current HSA definitions are not adequate for the development of a surgical Health Professional Shortage Area methodology. The ACS HPRI is redefining HSAs based on similar, but updated, data.