A lack of OB/GYN physicians is becoming an increasing concern across the country. The American College of Obstetricians & Gynecologists (ACOG) suggests that nearly half of U.S. counties do not have an obstetrician that is currently practicing. Heather Bartos M.D. practices at Texas Presbyterian Hospital in Denton. She sees roughly 30 patients each day, delivers approximately 25 babies each month, and is involved in surgery one day each week. Her schedule does not afford her regular break times and has a negative effect on her at-home parenting duties. In the coming years she plans to scale back her workload, but knows there is not currently another doctor that could assume some of her duties.
Shortage in Rural Areas
The ACOG explains that those residing in the larger metropolitan areas may not currently notice that the shortage of OB/GYNs exists—but are likely to in the coming years. The shortage can make it difficult for patients to locate an available doctor and face long lines in waiting rooms. Many women, particularly in rural areas, have decided to see a local nurse practitioner (NP) for care. In many of these regions practitioners such as physician assistants, NPs and nurse midwives are assuming a greater role in this area of care. The challenge for rural communities will be to incentivize OB/GYNs to locate in their area through added benefits such as assistance in paying medical school tuition loans.
Medical Malpractice Costs
Medical liability insurance coverage is a large cost for many OB/GYNs. This specialty faces some of the highest rates of malpractice cases. Dr. Bartos stated that these insurance costs may equate to “a third of your salary”. Dr. Valerie Jones was a physician in Maryland that decided to retire early, largely in response to the overwhelming liability insurance costs. Roughly 30% of these physicians stop practicing in the obstetrics area of the specialty within 12 years. Many decide to simply provide gynecological care, which allows for a more manageable work schedule and reduced stress. Jones and others feel that further reforms in medical liability are needed.
Lack of Available Care in D.C.
Back in September, the posting Closure of Washington D.C. Maternity Ward is Creating Difficulties for Many Mothers revealed how this problem exists right here in Washington D.C. During the course of 2017 both Providence Hospital & United Medical Center discontinued providing prenatal and maternity care. The departments were closed in response to poor safety results and failing to adhere to certain standards of practice. The Atlantic went as far as to classify this concern as being a “crisis”.
Long Hours & High Stress Profession
The shortage of physicians in this specialty poses a potential threat to a key aspect of women's health. The day-to-day workload can become heavy and often requires responding to patient concerns at night. OB/GYNs also struggle with the difficult realities of when the birth of a child ends badly. Physicians across all specialties of practice struggle with the continued emphasis placed on cost and efficiency instead of the quality of treatment.
Fewer Residency Programs & Males in the Profession
Dr. Hal Lawrence of ACOG said that residency program availability is limited in obstetrics & gynecology. These slots are mostly funded by the government and it is costly to expand the number of available slots for training. He hopes that more private funding arrangements may develop. In addition, as of 2015 roughly 55% of those in the profession were female. Approximately 80% of current OB/GYN residents are female. This is largely because it seems that younger women prefer female providers.