The Impact of Aging Population on General Surgical Workforce Needs

The older population over the age of 65 is rapidly growing and increasingly diversified. It is estimated that in 2050 1 in 5 people will be over 65 years old. This situation will lead to a significant increase in the demand on the healthcare system, especially in surgical specialties that treat older and often frail patients. This part of the population has significantly higher rates of inpatient and outpatient procedures than other age groups. The general surgical workforce must be sufficient to meet the demands for elective and emergency services. This condition will result in the need for an increase in both the workload per surgeon and the number of surgeons. Surgeons and all healthcare professionals must approach the frail population with specific skills and knowledge to provide optimal care. The association of multiple comorbidities and the physiological vulnerability status requires more complex and patient-centered care due to the higher risk in terms of morbidity, mortality, and poor functional recovery after surgery. Frail patient management should be integrated into the training of all healthcare professionals and should include a multidisciplinary team. It is necessary to improve the competence of the entire health workforce in working with geriatric patients, increase geriatric specialists, “geriatric surgeons,” and improve methods of delivering healthcare. Specific guidelines based on the comprehensive geriatric assessment (CGA) system should be applied for these patients that aid the best perioperative decisions. Prehabilitation programs, comorbidity management, and nutritional and psychological support are essential to reduce complications, prolonged hospital stays, readmission rates, post-discharge care requirements, and healthcare costs.