Shane Burke, Alan Wu, Shervin Eskandari, Dev Shah, Cole Kramer, Porter Young
Substantial rural-urban disparities exist in Florida's orthopedic workforce, with non-metropolitan counties facing pronounced shortages and longer travel distances for care. These findings support region-specific workforce planning and physician retention strategies to improve geographic equity as statewide demand continues to rise.
BACKGROUND: As Florida's population growth surges, access to orthopedic care is increasingly important, yet statewide geographic accessibility remains underexplored. This study aims to conduct a county-level analysis of the distribution and availability of orthopedic surgeons serving Florida's rural and urban populations.
METHODS: Orthopedic surgeons licensed to practice in Florida were identified using the Florida Department of Health Practitioner Profile database, including primary clinical practice address and residency training state. Counties were categorized as metropolitan (Rural-Urban Continuum Codes {RUCC} 1-3) or non-metropolitan (RUCC 4-9) using 2023 RUCC designations. County demographic and geographic variables were obtained from the 2020 US Census Bureau.
RESULTS: A total of 2,117 orthopedic surgeons were identified across Florida's 67 counties (45 metropolitan and 22 non-metropolitan), spanning 53,654 square miles. In total, 19 counties (28.4%) lacked a practicing orthopedic surgeon; 14 (73.7%) were classified as non-metropolitan. Metropolitan counties accounted for 2,098 (99.1%) surgeons, with the most urban counties (RUCC 1) exhibiting the greatest surgeon density and lowest average travel burden. The average surgeon density in metropolitan counties was 8.33 per 100,000 residents with an average travel burden of 8.24 miles, compared to a density of 1.79 surgeons per 100,000 residents and a longer average travel burden of 21.03 miles in non-metropolitan counties (p < 0.001).
CONCLUSIONS: Substantial rural-urban disparities exist in Florida's orthopedic workforce, with non-metropolitan counties facing pronounced shortages and longer travel distances for care. These findings support region-specific workforce planning and physician retention strategies to improve geographic equity as statewide demand continues to rise.