General surgeons have an essential role in the rural health care system. Th
is telephone survey of 39 rural general surgeons in Missouri found that mov
e than half were 55 or older Most reported they practiced a broader scope o
f surgery than colleagues in urban areas, and half believed that current re
sidency graduates are not prepared for surgical practice in rural areas. On
e-fifth had sought special training experiences to prepare them for rural p
ractice. On balance, 70 percent of the respondents' practices was general s
urgery, 13 percent "specialty surgery" and 17 percent primary care. Many re
ported feeling professionally isolated. One-fourth had literally "returned
home" to practice. The results suggest that if present trends continue, the
next 10 years will see a substantial reduction in the number of general su
rgeons in rural Missouri.