Essay · MedTech · AI
The surgeon shortage nobody is ready for, and what it demands of technology · Juan Vegarra · July 2026 · Leer en español
In December 2025, the federal Health Resources and Services Administration published its physician workforce projections through 2038. Buried in the tables is a number that should stop anyone in healthcare cold. By 2038, the vascular surgery workforce is projected to meet only 66 percent of demand.
Not 90 percent. Not 80. Sixty-six.
It is the deepest projected shortage of all 35 physician specialties the agency models, worse than ophthalmology at 72 percent and thoracic surgery at 73 percent, and it sits inside an overall projected shortfall of more than 141,000 physicians. These are the specialists who keep people walking, keep dialysis access working, and keep aneurysms from becoming obituaries.
The instinctive answer is to produce more surgeons. The math does not cooperate. The pipeline from medical school matriculation to independent vascular practice runs roughly a decade. A large share of the surgeons practicing today are approaching retirement, and surveys of the field show many planning to leave before 65, worn down by call schedules the public never sees. Meanwhile the demand curve only steepens: an aging population, more diabetes, more peripheral artery disease.
So the honest question changes. It is no longer how do we get more surgeons in time, because we will not. It is how does each surgeon accomplish more, without burning out the very people we cannot replace.
The academic literature has already quantified the gap. A recent peer-reviewed workforce model estimates that each vascular surgeon will need to increase annual output by 22 to 31 percent by 2030 just to absorb the workload. The same authors name the lever they believe can close it: the integration of AI and machine learning into surgical practice.
I have seen this movie before, from the beginning. I started my career in 1986 as the software developer on the ICU Research team at George Washington University, the team whose core deliverable was the APACHE Score. My job was to automate a paper-based system for the PC world, pulling data from ICU devices into a database and running regression analysis against a known dataset, so that clinicians could see severity and risk in a way paper forms never allowed.
The lesson from those years has held for four decades: the highest use of technology in medicine is to multiply clinician judgment, not to replace it. The intensivists did not want a machine to decide. They wanted to see more clearly, earlier, so their decisions were better. Every technology that has genuinely changed medicine since has followed that pattern.
If output per surgeon is the only variable left, there are three places to pull.
Get the first procedure right. In peripheral vascular disease, repeat interventions are the hidden tax on capacity. Every redo consumes surgeon-hours the system does not have. Better visualization and better intraprocedural decisions mean fewer returns to the table, and the freed hours go straight back into the queue of patients waiting.
Move care to where it is efficient. The shortage bites hardest where hospital capacity is scarcest. Office-based labs and ambulatory surgery centers can expand system capacity without adding a single surgeon, if the tools are built for their economics rather than retrofitted from the hospital.
Augment the operator. AI that standardizes image interpretation and compresses the learning curve does something no residency expansion can: it lets every surgeon, at every experience level, operate at the top of their capability. Augmentation, not replacement. The surgeons will tell you the difference matters, and they are right.
This is the problem we think about every day at VerAvanti, where we are building a hardware-enabled AI platform for interventional imaging. I will not make product claims here; that is what regulators and peer review are for. But I will say the design question behind everything we do is the one this workforce data forces: how does one surgeon safely do the work that demand says will soon require one and a half?
I came to this country as an outsider, and outsiders learn early that doing more with less is not a slogan. It is a discipline. Usually the phrase is a euphemism for budget cuts. In vascular care over the next decade it is simply arithmetic. The surgeons are already shouldering the work. The least the rest of us can do is build them tools worthy of it.
Sources: HRSA National Center for Health Workforce Analysis, Physician Workforce: Projections 2023 to 2038 (December 2025); Journal of Vascular Surgery workforce model (2020); peer-reviewed predictive modeling of vascular surgery trends using machine learning (2025).