Published 8/1/2015
Hazel Oreluk, MA; Sarah Eisinger, MS; John Cherf, MD, MPH, MBA

Orthopaedic Practice in the United States

Results of the 2014 OPUS/Census Survey

What’s the most popular orthopaedic specialty? Is there a potential shortage of orthopaedic surgeons? How many orthopaedic surgeons are women? How fast is hospital employment of orthopaedic surgeons growing?

These are the types of questions that reporters, researchers, and regulators ask. And the answers can be found in the Orthopaedic Practice in the United States (OPUS) Survey, also known as the AAOS Census Survey. Every 2 years, the Academy’s research and scientific affairs department gathers demographics and practice data on orthopaedic surgeons in the United States. The most recent data comes from 2014.

The information collected helps ensure that AAOS members are accurately represented, that Academy program and products evolve to reflect changes in membership, and that the AAOS continues to address the professional needs and interests of its members.

In this three-part series, we’ll discuss the results of the 2014 census and look at trends in orthopaedic practice in the United States.

Surgeon density
Surgeon density was computed using 2014 U.S. Census figures and 2014 orthopaedic surgeon count per state. Even though they are states with relatively low populations, Wyoming, Montana, New Hampshire, Vermont, and South Dakota had the highest surgeon density with more than 11 orthopaedic surgeons per 100,000 people.

Michigan, West Virginia, Arkansas, Texas, and Mississippi had the lowest surgeon density at 7 or fewer orthopaedic surgeons per 100,000 people. To find out how your state fares, check the surgeon density map (Fig. 1) or the online version of this article for a complete list of surgeon density by state (in decreasing order).

On average, the United States has 8.51 orthopaedic surgeons per 100,000 population, or one orthopaedic surgeon for every 11,751 people.

Age and gender
The average age of an orthopaedic surgeon is 56 years old. The state with the youngest average age is South Dakota (50.54 years); orthopaedic surgeons in New Mexico have the oldest average age (58.08 years).

More than 90 percent of the orthopaedic workforce is male (Fig. 2). (Individuals who did not answer the question on gender are classified as having an “unknown” gender.)

Fig. 3
shows the racial/ethnic breakdown among orthopaedic surgeons. The majority of the orthopaedic workforce is Caucasian. Asian Americans comprise the largest minority group, followed by Hispanics (2 percent), African Americans (1 percent), and multiracial (1 percent).

Practice setting
Members were asked to identify their practice setting (
Fig. 4). More than half of all respondents are in private practice. The most popular private practice setting was a single specialty group (35 percent), followed by solo practice (15 percent), and multispecialty group (10 percent). Academic practices (16 percent) and hospitals (15 percent) accounted for less than a third of practice settings. Locum tenens, military, health maintenance organizations, public institutions and other practice settings accounted for the remaining 9 percent.

Degree of specialization
More than half (57 percent) of the orthopaedists responding to the survey identified themselves as specialists (
Fig. 5), while 27 percent identified themselves as generalists with a specialty interest. Just 16 percent of respondents identified themselves as generalists.

Areas of focus
The 2014 census asked AAOS members to identify their specialty areas. The top five areas of focus identified were arthroscopy, adult knee, shoulder/elbow, adult hip, and sports medicine.

2016 will be a census year
The next census data gathering year will be 2016. Questionnaires will be sent to AAOS members via email, fax, or mail. As always, we seek a 100 percent response rate so orthopaedic surgeons are encouraged to answer the survey as soon as they receive it during the first quarter of 2016. The second article in this series will focus on orthopaedic workforce trends.

A link to the full 2014 OPUS report, which can be downloaded and is available at no cost to AAOS members, can be found here.

Hazel Oreluk, MA, is manager and Sarah Eisinger, MS, is a research analyst in healthcare statistics and surveys, in the AAOS department of research and scientific affairs. John Cherf, MD, MPH, MBA, is the current chairman of the AAOS Practice Management Committee.