In a front page story on New Year's Day, the Washington Post finds that a dwindling number of general surgeons are to be found in rural communities. General surgeons are the "essential ingredient that keeps full-service medical care within reach" of rural residents, reports David Brown. But the number of general surgeons graduating each year hasn't increased since 1980,   even though the country's population has increased by 79 percent. There are shortages of general surgeons everywhere."Nevertheless, it's in rural America — where some places have only half as many surgeons per capita as cities — that the problem is most acute," Brown writes. "And it's likely to get worse. More than half of rural general surgeons are older than 50, and a wave of retirements is expected in the coming decade." Without surgeons locally, hospitals have to fly patients to metro facilities. That's hard on patients, and it's hard on the finances of rural hospitals that are losing business.