Academic Journal
Locum tenens coverage and access to pediatric surgical care in the United States.
| Τίτλος: | Locum tenens coverage and access to pediatric surgical care in the United States. |
|---|---|
| Συγγραφείς: | Martin AE; 324 Colony Blvd, Lexington, KY 40502, USA. Electronic address: aemartin55@hotmail.com., DeRoss AL; Division of Pediatric General Surgery, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Avenue, R3, Cleveland, OH 44195, USA., Jang SG; School of Marine and Atmospheric Sciences, Stony Brook University, Stony Brook, NY 11794, USA., Greene AC; Department of Surgery, Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA., Vu MT; Expeditionary Medical Facility 150 Mike, Naval Hospital Jacksonville, 2080 Child St., Jacksonville, FL 32214, USA., Hamilton NA; Peacehealth RiverBend, 3333 RiverBend Dr., Springfield, OR 97477, USA., Ladd MR; Department of Surgery, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA., Lotakis DM; Indiana University, Riley Hospital for Children, 705 Riley Hospital Drive, Indianapolis, IN 46201, USA., Robie DK; Dayton Children's Hospital, 3391 20 Mile Road, Ponte Vedra, FL 32081, USA., Romain C; University of Chicago, 5839 S. Maryland Ave., Chicago, IL 60637, USA., Edwards MJ; Albany Medical College, Albany, NY 12208, USA., Kennedy AP; Janet Weis Children's Hospital, Geisinger Health System, 100 N Academy Ave, Danville, PA 17822, USA., Zagory JA; Division of Pediatric Surgery, Department of Surgery, LSU Health New Orleans, 2021 Perdido Street, New Orleans, LA 70112, USA., Sutyak KM; University of Nebraska Medical Center, Omaha, NE 68198, USA., Fallat ME; Hiram C. Polk, Jr., MD, Department of Surgery, University of Louisville School of Medicine, Norton Children's Hospital, 315 E Broadway, Suite 565, Louisville, KY 40202, USA., Zeug A; ThedaCare, 100 Theda Clark Plaza Suite $400, Neenah, WI 54956, USA., Chandler NM; Division of Pediatric Surgery, Johns Hopkins All Children's Hospital, 501 6th Street South, Saint Petersburg, FL 33705, USA., Badru FO; CAMC Pediatric Surgery, Vandalia Health, 830 Pennsylvania Ave., Suite 202, Charleston, WV 25302, USA., Wadie G; Carolina Pediatric Surgery, 400 Asheville Ave., Suite 200 B, Cary, NC 27518, USA., Iocono J; Department of Surgery, Akron Children's Hospital, 215 West Bowery St., 6th Floor, Akron, OH 44308, USA., Wolf LL; Division of Pediatric Surgery, University of Arkansas for Medical Sciences/Arkansas Children's Hospital, Little Rock, AR 72022, USA., Purcell LN; Division of Pediatric Surgery, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390, USA., Browne M; Division of Pediatric Surgery, Lehigh Valley Health Network, 1210 S Cedar Crest Blvd, Suite 1100, Allentown, PA 18103, USA., Bonasso PC; WVU Medicine Golisano Children's Hospital, 1 Medical Center Drive, Morgantown, WV 26506, USA., Prasad R; St. Luke's Children's Hospital, 701 Ostrum Street, Suite 102, Bethlehem, PA 18015, USA., Alaish SM; Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA., Ricca R; Division of Pediatric Surgery, 500 University Drive, Hershey, PA 17033, USA., Gow KW; Division of Pediatric Surgery, Stony Brook University Hospital, 101 Nicolls Road, Stony Brook, NY 11794, USA. |
| Πηγή: | Journal of pediatric surgery [J Pediatr Surg] 2026 Jul 20, pp. 163300. Date of Electronic Publication: 2026 Jul 20. |
| Publication Model: | Ahead of Print |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Saunders Country of Publication: United States NLM ID: 0052631 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1531-5037 (Electronic) Linking ISSN: 00223468 NLM ISO Abbreviation: J Pediatr Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: Philadelphia, PA : Saunders Original Publication: New York. |
| Περίληψη: | Purpose: Workforce shortages and geography may limit access to pediatric surgical care. Locum tenens (LT) surgeons help fill staffing gaps, yet their role in pediatric surgery remains poorly defined. This study evaluates the prevalence, practice settings, and clinical coverage of LT pediatric surgeons to inform workforce planning and access strategies. Methods: The American Pediatric Surgical Association (APSA) membership list was used to identify United States pediatric surgery practices. Each practice was contacted to obtain data on surgeon composition, use of LT, advanced practice providers (APPs) composition, and the number of hospitals, clinics, consultation sites, and operating rooms covered as of July 31, 2025. Service locations were geocoded by zip code. Values are expressed as median and interquartile range [IQR]. Comparisons between practices using and not using LT were done by Mann-Whitney U tests, with p < 0.05 considered significant. Results: Of 248 practices, 59 (23.8%) reported using LT. LT practices are in 29 of 50 states and the District of Columbia (56.9%), most commonly in Florida (n = 6), Texas (n = 5), New Jersey, and Pennsylvania (n = 4 each). LT surgeons cover a median of 1 [1-1] hospital. Compared with non-LT (NLT) practices, groups using LT were significantly smaller (median 2 [2-3] vs. 4 [3-6.5] surgeons, p < 0.001) and less likely to host a fellowship (8.5% vs. 24.9%, p = 0.006). They covered fewer hospitals, clinics, consultation sites, and operating sites (all p < 0.01). APP employment and practices that cross state lines were similar between groups. Maintaining LT-supported practices substantially improves access, reducing median travel distances by almost half (from 48.6 to 29.2 miles across state lines and from 51.5 to 31.3 miles within state lines). The proportion of children living >60 miles from surgical care dropped from 19.9% to 6.7%, reducing the number affected from ∼14.5 million to about 5 million. Conclusions: LT surgeons play a critical role in pediatric surgery, expanding access and reducing travel distances for children, particularly in smaller, non-fellowship practices. While LT reliance helps fill gaps, it also highlights potential workforce vulnerabilities. Understanding LT utilization is essential for planning a resilient pediatric surgical workforce and ensuring equitable care nationwide. (Copyright © 2026 Elsevier Inc. All rights reserved.) |
| Competing Interests: | Conflicts of interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ME Fallat, MD, serves as an Associate Editor at the Journal of Pediatric Surgery. KW Gow, MD, and NM Chandler, MD, serve as Assistant Editors at the Journal of Pediatric Surgery. Given their role as Associate or Assistant Editors of the Journal of Pediatric Surgery, they had no involvement in the peer review of this article and had no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to another journal editor. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. |
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| Grant Information: | UL1 TR001998 United States TR NCATS NIH HHS |
| Contributed Indexing: | Keywords: Locum tenens; Pediatric surgery; Workforce |
| Entry Date(s): | Date Created: 20260720 Latest Revision: 20260923 |
| Update Code: | 20260923 |
| PubMed Central ID: | PMC13592455 |
| DOI: | 10.1016/j.jpedsurg.2026.163300 |
| PMID: | 42476218 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1531-5037 |
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| DOI: | 10.1016/j.jpedsurg.2026.163300 |