Family Medicine and Obstetrics: Let’s Stop Pretending

It is time to stop pretending that delivering babies is one of the core activities of family medicine. At no time in the history of American family medicine have the majority of the members of the American Academy of Family Physicians (AAFP) delivered babies. A study in 1982 found that approximately 44% of family physicians delivered babies1, another study reported 43% in 19862, another 26% in 19933, and the most recent data from the AAFP states the current number is 17.1%.4 The way forward from these trends should not be to continue business as usual. Barreto et al5 found that 13% of 2016 family medicine residency graduates deliver babies. Almost half the respondents were not interested at all in obstetrics practice (889/2018). Of those left who did not deliver babies, 60% mentioned lack of availability of jobs where family physicians in practice deliver babies as the reason and 60% mentioned lifestyle considerations, followed by malpractice costs and privileging challenges. These realities have implications for family medicine residency education and the basket of services provided by its graduates.