Opportunities and Barriers for Family Physicians in Maternity Care
The number of family physicians practicing maternity care has been declining over the past 20 years, with only 8% currently including deliveries in their practice. The American College of Obstetricians and Gynecologists has projected a growing shortage in the obstetric workforce. This decline is concerning for rural areas where family physicians provide the majority of maternity care. However, recent data show that early career family physicians plan to include maternity in their practice at much higher rates. Unfortunately, the number one reason reported by many of these family physicians for not doing so was that they were not able to find jobs that allowed them to include this broader scope of care in practice.
Of the 1,016 survey respondents who had previously indicated that they planned to provide maternity care in their practice after graduation, 68.9% reported currently including deliveries in their practice one to three years later. The results showed no difference in physician gender or type of medical degree (MD, DO), but geographic variation was notable: less than 50% practicing in the Middle Atlantic and West South Central regions were delivering babies, while 75% or more were doing so in the East North Central, West North Central and Mountain divisions. Those currently providing maternity care were more likely to practice in a small rural or isolated community (15.4%) and to report that credentialing was easy (85.2%).
The most significant reason that recent family physician graduates did not include maternity care in practice as intended was that they found a job that did not include obstetrics (26.2% of respondents not practicing obstetrics). This could be attributed to new physicians entering the workforce as employees rather than as practice owners, indicating that family medicine scope of practice is being influenced by external forces. The second most commonly cited reason was lifestyle concerns (reported by 18.7% of respondents), which may be related to practice call structure. Further research is necessary to understand the institutional, regional, and state regulatory barriers preventing family physicians from providing maternity care to those who need it.
The complete article can be found here: https://journals.stfm.org/familymedicine/2019/may/barreto-2018-0183/
Correspondence and inquiries should be addressed to: Aimee Eden, PhD, American Board of Family Medicine; email: [email protected]