The Economics of Volunteering Abroad: Results from a Comprehensive Survey of American Society of Plastic Surgery (ASPS) Members

Purpose: In the fall of 2014, we undertook a society wide survey of all ASPS members to “biopsy” the current care being provided abroad by volunteer American plastic surgeons. While it is commonly understood within our specialty that each year hundreds of plastic surgery volunteer trips work abroad, the demographics of this significant workforce has been inadequately studied in the medical literature, forming a major barrier to improving international delivery systems for surgical services, cultural competency in US surgical education and sustainable models for international surgical education. In this presentation we report key economic and demographic data related to surgeons who volunteer abroad and those who do not.

Methods and Materials: In the fall of 2014, a validated email survey tool was delivered to all board certified plastic surgeons. The methodologically sound survey, with statistical analysis of responses including regression and multivariate analysis, collected data points on clinical outcomes, educational outcomes, and demographic information about traveling and non traveling surgeons.

Results: The survey response rate was 15% (745 total respondents.) 314 surgeons traveled on a volunteer trip in the last 5 years, 173 surgeons have volunteered internationally but not in the last 5 years and 253 surgeons never volunteered abroad.

21.1% (62) volunteer surgeons contributed more than $3000 to participate in their last trip, 24.1% (71) contributed $1000-$2000. Surgeons who do not volunteer abroad most commonly site as their reason, “Unable to take time from my practice in the US” (69.2% 148) and write-in comments were significant for, “I do my charity care in the US.” Trends in age, race, gender, practice model and plastic surgery subspecialty amongst volunteering and non volunteering surgeons will also be reviewed in the presentation.

The most common duration of a volunteer trip was 8-10 days (38.6%, 113) and on their most recent volunteer trip, 293 surgeons provided a total estimated 2,368 days of surgical services abroad.

Conclusions: Financial considerations are a significant factor for plastic surgeons considering volunteer work, both in direct cost for travel abroad and the opportunity cost of time away from their primary practice. On their last trip alone, surgeons who volunteered internationally in the last 5 years provided an estimated total of 2,368 days of surgical services abroad.