Developments in Brief : U.S. Has More Surgeons but Fewer Operations; Loss of Expertise Feared

The number of operations nationwide, after steadily increasing in recent years, has started to decline--even though there are more surgeons than ever, a gap that is expected to widen, medical experts say.

The two trends raise the possibility that the overall quality of surgical care may suffer because surgeons typically must operate frequently to maintain their proficiency, said Dr. Ira Rutkow of the University of Medicine and Dentistry of New Jersey.

Government data show that 16.9 million operations were performed in the United States in 1985, down by about 200,000 since 1979. At the same time, the number of surgeons has increased by 25% since 1979, to 121,200 last year.

Rutkow’s data appear in the October issue of Archives of Surgery. An accompanying editorial called on the profession to concentrate on increasing the quality of surgeons--not the quantity.

“This quality will save millions of dollars because surgical complications are the most threatening cost-multiplier in surgery,” wrote Dr. Francis Moore of the Harvard University Medical School.

Rutkow said the decrease in the number of surgical procedures performed in the nation is probably the result of such factors as the increasing trend for patients to seek second opinions before undergoing surgery, better non-surgical treatment and improved diagnostic procedures that rule out the need for surgery.

The most common operation performed in the United States is the Caesarean section, followed by hysterectomies; dilation and curettage of the uterus for diagnostic purposes; cataract extractions, closure of the Fallopian tubes and tonsillectomies.