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The condition of surgery: an analysis of the American College of Surgeons' and the American Surgical Association's report on the status of surgery.

The supply of surgical services--a function of both the number of surgeons and the amount of surgery each performs--was extensively studied as a basis for new public policies in medical practice. The Report concludes that there is a surplus of physicians performing surgery and recommends restricting their number through more rigorous board certification and reducing the number of new entrants to specialized training. But the technological criteria advanced to assure "quality" are not based on adequate empirical evidence; and control by surgeons over their own numbers is likely to have uneven--and unfavorable--consequences for the public. The causes of surplus surgical capacity must be explained, and impediments to self-correction through competition in the "medical market" addressed in future policy.