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The increasing workload in head and neck surgery: An epidemiologic analysis


  • Neil Bhattacharyya MD, FACS

    Corresponding author
    1. Division of Otolaryngology, Brigham and Women's Hospital, Boston, Massachusetts, and Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.
    • Division of Otolaryngology, 45 Francis St., Boston, MA 02115
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  • Neil Bhattacharyya, MD, is a consultant for Intersect-ENT, Inc. and Entellus, Inc. The author has no other funding, financial relationships, or conflicts of interest to disclose.



Determine if there might be an increase in the workload for head and neck surgery based on an aging population.

Study Design:

Cross-sectional analysis of a national database.


The frequency of head and neck surgical procedures (HNSPs) performed in 2006 in the inpatient and outpatient settings in the United States were assessed using the National Hospital Discharge Summary and the National Survey of Ambulatory Surgery, respectively. From US Census Bureau statistics, age-specific HNSP rates were determined and projected to the 2020 population based on census bureau predicted changes in population demographics. The surgical workload burden was assessed in 2006 and projected to 2020 based on the predicted changes in procedure rates and resource-based relative value scale.


An estimated 366,050 HNSPs (142,397 inpatient vs. 223,653 outpatient) were performed in 2006 requiring a total of 2.49 million physician work relative value units (RVUs). With the expected changes in population demographics in 2020, an estimated 422,183 HNSPs will be performed (163,781 inpatient vs. 258,402 outpatient) requiring 2.88 million work RVUs in head and neck surgery. Both the HNSP rate and projected RVUs increase approximate 15.3%.


Based on national health statistics and US census data we can anticipate a substantial increase in the workload for head and neck surgeons. Efforts should be directed at assessing manpower requirements in head and neck surgery based on the impact of an aging US population. Laryngoscope, 2011