It is unclear whether the current distribution of surgeons practicing female pelvic medicine and reconstructive surgery in the United States is adequate to meet the needs of a growing and aging population. We assessed the geographic distribution of female pelvic surgeons as represented by members of the American Urogynecologic Society (AUGS) throughout the United States at the county, state, and American Congress of Obstetricians and Gynecologists district levels.
County-level data from the AUGS, American Congress of Obstetricians and Gynecologists, and the United States Census were analyzed in this observational study. State and national patterns of female pelvic surgeon density were mapped graphically using ArcGIS software and 2010 US Census demographic data.
In 2013, the 1058 AUGS practicing physicians represented 0.13% of the total physician workforce. There were 6.7 AUGS members available for every 1 million women and 20 AUGS members for every 1 million postreproductive-aged women in the United States. The density of female pelvic surgeons was highest in metropolitan areas. Overall, 88% of the counties in the United States lacked female pelvic surgeons. Nationwide, there was a mean of 1 AUGS member for every 31 practicing general obstetrician-gynecologists.
These findings have implications for training, recruiting, and retaining female pelvic surgeons. The uneven distribution of female pelvic surgeons throughout the United States is likely to worsen as graduating female pelvic medicine and reconstructive surgery fellows continue to cluster in urban areas.
Members of the American Urogynecologic Society are unevenly distributed into metropolitan areas across the United States.
From the *Division of Female Pelvic Medicine & Reconstructive Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO; †Department of Natural Resources and Environment, Naresuan University, Muang, Thailand; ‡Female Pelvic Medicine and Reconstructive Surgery, Cleveland Clinic, Cleveland, OH; and §Female Pelvic Medicine and Reconstructive Surgery, Hartford Hospital, Hartford, CT.
Reprints: Tyler M. Muffly, MD, Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Colorado Anschutz Medical Campus, 12631 East, 17th Avenue, Box B198-2, Room 4208 Aurora, CO 80045. E-mail: firstname.lastname@example.org.
The authors have declared they have no conflicts of interest.