Subspecialization of Surgical Specialties in the US

How has surgical subspecialization evolved in the US, and what are its implications for generalist surgeons and geographic access to care?In this retrospective cohort study of more than 70 000 surgeons using Medicare data from 2000 to 2021, the share of subspecialists rose from 38% to 58%. Subspecialist growth was associated with reduced procedural scope among generalists and substantial geographic variation in access.Surgical subspecialization has expanded considerably, narrowing generalist roles and contributing to uneven access to specialized care across regions.

Corresponding Author: René Karadakic, PhD, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA 02115 (rkaradakic@hsph.harvard.edu).

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