The U.S. had 16,260 orthopedic surgeons in 2021. By 2025, that number had dropped to 14,100, according to Bureau of Labor Statistics data, while the Health Resources and Services Administration projects a 12% shortage by 2038.
Beckers’ recent coverage has highlighted three areas that could affect the orthopedic and spine workforce: surgeon well-being after adverse outcomes, day-to-day practice operations and broader changes to training and practice structure.
Level 1: the individual surgeon carries adverse outcomes alone. Spine surgeons are especially exposed to what researchers call “second victim syndrome:” the stakes of an error are high, patient relationships built over months deepen personal responsibility when something goes wrong, and a surgical culture that rewards perfectionism discourages surgeons from acknowledging distress.
Safdar Khan, MD, and Todd Albert, MD, writing in the Summer 2026 issue of Vertebral Columns, found that surgeons consistently identify colleagues who understand operative practice as their most valuable source of support after an adverse event, and called for spine societies and training programs to formalize peer-support networks, confidential debriefing pathways and wellness champions.
Level 2: the team absorbs day-to-day operational strain: Vijay Yanamadala, MD, of Hartford (Conn.) HealthCare, said AI documentation tools have let him leave work refreshed rather than finishing notes at night, and that empowering advanced practice providers to handle more clinical assessment lets the team work at the top of its capabilities.
He described building in space to debrief complex cases and acknowledge difficult outcomes without blame, framing the goal around autonomy, mastery and purpose rather than productivity targets. Sohaib Hashmi, MD, of UCI Health in Orange, Calif., pointed to a different lever: setting realistic goals early in a career and protecting time for sleep, nutrition and exercise as a sustainability practice.
Level 3: the system itself has to change: Amit Jain, MD, vice president of care transformation at Johns Hopkins Medicine in Baltimore, called for three structural changes: integrating musculoskeletal education into pre-clinical medical school years rather than late-stage electives, moving to competency-based training using simulation and virtual reality, and building flexible practice models, including staggered call systems and AI-driven documentation support, to retain mid-career surgeons.
Separately, Lori Pagan, CEO of Orthopaedics NorthEast in Fort Wayne, Ind., said organizations that invest in advanced practice providers, AI-assisted documentation and physician leadership development create environments where surgeons can focus on patients rather than bureaucracy, and argued that giving surgeons real input into governance, compensation design and quality initiatives is often a stronger retention tool than compensation alone.
Why this matters for service-line leaders: The perspectives point to potential workforce strategies at the individual, practice and organizational levels. These include peer-support programs after adverse events, greater use of advanced practice providers and AI documentation tools, flexible staffing models, physician leadership development and changes to medical education.
The sources addressed these issues separately, and the available coverage does not establish which interventions have the greatest effect on recruitment or retention, how organizations should prioritize them or whether strategies implemented at only one level are sufficient.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.