Published 7/1/2017
John Cherf, MD, MPH, MBA; Angela Buckley, MPA

Orthopaedic Practice in the United States

Results of the 2016 OPUS/Census Survey
Every 2 years, the AAOS research, quality, & scientific affairs department gathers demographic and practice data on orthopaedic surgeons through the Orthopaedic Practice in the United States (OPUS) Survey, also known as the Census Survey. The most recent data comes from the 2016 Census Survey, which had a response rate of 26 percent.

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.

Surgeon density
Surgeon density was computed using 2015 U.S. Census figures and 2016 orthopaedic surgeon count per state. Wyoming, New Hampshire, Montana, Vermont, and Alaska had the highest surgeon density with more than13 orthopaedic surgeons per 100,000 people (ie, a population of 7,692 or less per orthopaedic surgeon).

Arkansas, West Virginia, Nevada, Mississippi, and Texas had the lowest surgeon density at 7.5 or fewer orthopaedic surgeons per 100,000 people (ie, population of 13,333 or more per orthopaedic surgeon).

To find out how your state stacks up, see 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).

Age and gender
The average age of an orthopaedic surgeon is 56.5 years old. Most (92 percent) of the orthopaedic workforce is male (Fig. 2). For a list of average ages by state, see the online version of this article.

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 Hispanic/Latino and other, African Americans, and Native American.

Practice setting
Members were asked to identify their practice setting (Fig. 4). The most popular practice setting was private practice–group (35 percent), followed by academic practice (both salaried by academic institution and by private practice) (19 percent), hospital/medical center (17 percent), private practice–solo (11 percent), and private practice–multispecialty (9 percent). Locum tenens, military, health maintenance organizations, public institution, and other practice settings accounted for the remaining 9 percent.

Degree of specialization
More than half (58 percent) of the orthopaedists who responded to the survey identified themselves as specialists (Fig. 5), while 25 percent were generalists with a specialty interest. The remaining 17 percent identified themselves as generalists.

Areas of focus
The 2016 Census Survey asked orthopaedists to identify their specialty areas. The top six areas of focus identified were sports medicine, total joint, hand, adult spine, trauma, and pediatric orthopaedics.

2018 will be a census year
The next census data gathering year will be 2018. Questionnaires will be sent to AAOS members via email, fax, or mail. As always, we seek a 100 percent response rate; orthopaedic surgeons are therefore encouraged to answer the survey as soon as they receive it during the first quarter of 2018.

The full 2016 OPUS report is available to AAOS members at www.aaos.org/aaoscensus/ AAOS log-in and password are required to view the report, which is also available for purchase.

John Cherf, MD, MPH, MBA, is the practice and payment section leader of the Health Care Systems Committee, a member of the Council on Education, and a member of the AAOS Now editorial board. Angela Buckley, MPA, is a research analyst in healthcare statistics and surveys in the AAOS department of research, quality, and scientific affairs.

Editor's note: This article is the first of a three-part series that discusses results from the 2016 Census Survey and examines trends in orthopaedic practice in the United States.