A recent US study published in JAMA Surgery analyzed national mortality data and found that surgeons had significantly higher mortality risk than other doctors, highlighting the occupational toll of surgical practice.

The analysis found that death rates of surgeons were 56% higher than those of nonsurgeon physicians, raising urgent questions about the workplace conditions, stressors, and lifestyle burdens unique to the profession.

Although decades of research have examined mortality among physicians and healthcare professionals, data specific to surgeons are scarce.

Long hours, high-stress environments, workplace violence, and occupational exposure to ionizing radiation place surgeons at particular risk.

Study Findings

Researchers examined US death certificate records from the 2023 National Vital Statistics System for adults aged 25-74.

The records included demographics, cause of death, and usual occupation as reported by the informant.

Mortality rates were calculated using population denominators from the 2023 American Community Survey, stratified by age, sex, and profession.

The figures for surgeons and physicians were cross-referenced with the AMA Physician Masterfile, a population-based registry of physicians.

Nonsurgeon physicians served as the primary comparison group, while lawyers, engineers, and scientists were included because of similar education and income profiles. All other professionals were grouped separately for the analysis.

Mortality rates were age- and sex-adjusted to the 2000 US standard population using direct standardization. Mortality rate ratios (MRRs) were used to quantify relative risks across professional groups.

The study included 1,080,298 deaths, comprising 224 surgeons (0.02%) and 2740 other physicians (0.25%).

The age- and sex-adjusted mortality rate per 100,000 was higher for surgeons (355.3; 95% CI, 274.5-458.8) than for nonsurgeon physicians (228.4; 95% CI, 218.7-238.4), yielding an MRR of 1.56 (95% CI, 1.36-1.78).

The adjusted mortality rate of surgeons was similar to that of lawyers, engineers, and scientists (404.5; 95% CI, 397.5-411.6; MRR, 0.88; 95% CI, 0.77-1.00) but lower than that of the broader workforce (632.5; 95% CI, 631.3-633.7; MRR, 0.56; 95% CI, 0.49-0.64).

Cancer and cardiovascular disease remained the leading causes of death across all occupations; however, distinct patterns emerged among surgeons.

Road traffic accidents ranked as the fourth most common cause of death among surgeons compared with ninth rank in other professions.

Surgeons were also more likely to die from hypertension-related diseases and assaults. Cancer mortality was notably higher among surgeons (193.2; 95% CI, 128.2-284.0) than among nonsurgeons (87.5; 95% CI, 81.4-94.0), with an MRR of 2.21 (95% CI, 1.75-2.80).

Occupational Risks

Nonsurgeon physicians showed reduced mortality relative to other high-income professionals, but this pattern was not observed among surgeons.

The elevated risk may reflect differences in workplace demands, schedules, and exposures. The results indicate that several causes of death, such as road traffic accidents, affect surgeons more, which is consistent with data showing that road traffic accidents related to long working hours are more frequent among surgeons.

A limitation of this study is that only 2023 data were available, which prevented the analysis of annual mortality trends. The small number of surgeon deaths reflects the workforce size as all eligible deaths were included.

This story was translated from JIM.