The U.S. is projected to face a growing orthopedic surgeon shortage, but the national numbers obscure a deeper problem: Rural communities could have enough surgeons to meet barely half their projected demand within the next decade.
By 2038, the nation’s orthopedic workforce is expected to meet just 88% of demand, according to a report from the Health Resources and Services Administration’s National Center for Health Workforce Analysis. A separate study published by the American Academy of Orthopaedic Surgeons projects workforce adequacy of 52% in nonmetropolitan areas by 2036, compared with 95% in metropolitan areas.
The figures point to a challenge extending beyond the number of surgeons available. Geographic disparities, growing demand and mounting pressure on existing practices could leave some communities struggling to maintain access to orthopedic care.
The shortage is already being felt
The impact of specialist shortages is already being felt in spine care.
Lali Sekhon, MD, PhD, of Reno (Nev.) Orthopedic Center, said physician retirements and departures have made it increasingly difficult to maintain access to spine surgery in his community.
“We have fewer spine surgeons now than when I first came to Reno in 2005,” Dr. Sekhon told Becker’s.
He said replacement physicians have not arrived quickly enough to offset those departures. In January, he reported that his next available appointment was in March, highlighting how workforce constraints can translate into longer waits for patients.
The geographic divide is expected to widen. A study published in the Journal of the American Academy of Orthopaedic Surgeons projects orthopedic surgeon supply will decline 2% by 2036 while demand increases as much as 13%.
Nine states already have fewer than three orthopedic surgeons per 100,000 residents, with Idaho, Illinois and Georgia reporting some of the lowest rates.
Demand is growing as the workforce contracts
The shortage comes as the U.S. population ages, increasing the need for musculoskeletal care.
The number of Americans 65 and older reached 61.2 million in 2024, up 13% since 2020, according to Census Bureau figures.
Meanwhile, workforce projections suggest orthopedic surgeon supply may struggle to keep pace with growing demand.
The training pipeline faces constraints as well. There were 4,437 active orthopedic surgery residents during the 2024-25 academic year, and every orthopedic residency position was filled in the 2025 match cycle.
Financial pressures threaten the existing workforce
Workforce shortages are not the only threat to orthopedic access. Financial pressures are also making it harder for some independent practices to sustain operations, potentially leaving patients with fewer options for care.
Zachary Lum, DO, a hip and knee replacement surgeon now employed by UC Davis Health, spent months working without a paycheck before leaving his former South Florida private practice. The group had stopped paying its physicians to continue paying staff and covering operating expenses.
“Those costs never go down, right? They only go up,” Dr. Lum told Becker’s. Dr. Lum warned that continued financial pressure could accelerate independent practice closures, limiting patients’ choices and potentially increasing healthcare costs.
Workforce concerns also extend to the aging physician population. Les Jebson, administrator of the Orthopedics and Sports Medicine Network at Greenville, S.C.-based Prisma Health, previously told Becker’s that an aging orthopedic surgeon workforce could intensify staffing challenges as demand grows for revision procedures involving existing joint implants.
Burnout adds another layer of risk
Nearly 1 in 5 orthopedic surgeons experiencing burnout said their symptoms were severe enough that they were considering leaving medicine, according to Medscape’s 2026 “Orthopedist Burnout & Depression Report,” as reported by Becker’s.
Bureaucratic tasks were the leading contributor to burnout, cited by 67% of affected orthopedists. Lack of respect from administrators, employers, colleagues or staff followed at 41%, while 39% cited insufficient autonomy.
Among orthopedists reporting burnout, 28% said they had reduced their working hours, while 24% had changed jobs or practice settings. Although considering leaving medicine does not necessarily translate into departure, the findings underscore a growing retention challenge for a specialty already facing projected workforce shortages.
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