(1) There will not be enough surgeons in the 7 surgical specialties studied. (2) We will have to train more than 100,000 surgeons by 2030 to maintain access for our citizens at an annual cost of almost $2 Billion and total cost of about $37 billion. (3) To train the extra needed surgical workforce will cost an additional $10 Billion. (4) To do this, the Balanced Budget Act of 1997 must be revised to permit more residents to be trained in the United States or other alternatives explored.
Because of steady population growth and the retirement of more than half the current workforce, the psychiatrist workforce will continue to contract through 2024 if no interventions are implemented, leading to a significant shortage of psychiatrists. Despite an expected workforce expansion beginning in 2025, it is unclear whether the shortage will completely resolve by 2050. Future research should focus on developing strategies to address this quantified shortage in an effort to curb the worsening shortage through 2024 and over the coming decades.
Assessment of collateral circulation to the hand is required prior to invasive procedures or harvesting of the radial artery (RA). A modified Allen's test (MAT) is commonly used to assess palmar arch collaterals. A variety of non-invasive methods including digital pressures, plethysmography, pulse oximetry and duplex ultrasonography are available to supplement physical examination. However, no consensus exists about the proper role of the MAT and the most appropriate non-invasive test (NIT) in this situation. Interpretation of the MAT and NIT findings are also controversial. This paper reviews the anatomy and the physiologic basis for the MAT and various NITs, the pros and cons of various NITs and recommendations for the assessment of collateral circulation to the hand prior to interventions directed at the RA.
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