CORR Insights®: What is the Geographic Distribution of Women Orthopaedic Surgeons Throughout the United States?

It is estimated that by 2050, there will no longer be any clear racial and ethnic majority in the United States. Indeed, Americans of Hispanic and Asian descent comprise of the fastest-growing population segments [5]. As the US population becomes more diverse, the need for diversity and multi-culturalism in medicine will become ever-more essential. The characteristics of many clinical encounters today, including time pressure, cognitive complexity, and cost-containment measures, increase the likelihood of care poorly matched to minority patients’ needs [14]. Additionally, minority patients may experience a range of other obstacles to accessing care, including barriers of language, geography, and cultural familiarity [14]. In addition to race and gender, workplace diversity includes variation in age, ethnicity, physical attributes, educational background, sexual orientation, geographical location, socioeconomic status, marital and parental status, spiritual practice, and previous work experience. Any organization’s growth and success depend upon its ability to understand and effectively meet the needs of an increasingly diverse customer-patient population. Diverse organizations also benefit from enhanced: (1) Adaptability to fluctuating conditions and patient demands, (2) skillsets and competencies extending the range of potential customers-patients, and (3) idea pools and innovative solutions [6, 7, 19]. The Council on Graduate Medical Education first expressed concern about the growing disparity between the physician specialty and geographic maldistribution in 1988, despite an increasing aggregate supply of physicians within the United States. It found that “the composition of the Nation’s physicians [did] not reflect the general population” contributing to a “crisis in health care delivery” [9]. In 2011, the Association of American Medical Colleges (AAMC) reported a continued maldistribution of physicians by specialty and geography [1]. Men far outnumber women in nearly all surgical subspecialties, and surgeons of color are underrepresented across the board in medicine—a disparity that is even more severe in surgery [11, 12]. This is problematic for many reasons, not least of which is that patient-physician raceconcordance has been demonstrated to have higher patient satisfaction ratings; the same has been shown for patientphysician gender concordance [22]. Definite signs of progress are visible in medical schools and in some subspecialties during residency for women and under-represented minorities. For instance, women have increased from 48% to 51% of medical school matriculants since 2002. Women also account for the majority of graduate medical education trainees in obstetrics and gynecology, pediatrics, dermatology, internal medicine/ pediatrics, familymedicine, pathology, and psychiatry [2, 12]. Moreover, from 1995 to 2010, the percentage of women faculty members in orthopaedic departments has nearly doubled (from 4.9% to 8.1%), as did black This CORR Insights is a commentary on the article “What is the Geographic Distribution ofWomenOrthopaedic Surgeons Throughout the United States?” by Chapman and colleagues available at: DOI: 10.1097/CORR.0000000000000868. The author certifies that neither he, nor any members of his immediate family, have any commercial associations (such as consultancies, stock ownership, equity interest, patent/ licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. The opinions expressed are those of the writer, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. A. E. Johnson MD, FACS, FAOA (✉), Dell Medical School/UTHealth Austin, University of Texas at Austin, 1701 Trinity Street, MC Z0800, Austin, TX 78712, USA, Email: AJ. Johnson@austin.utexas.edu