The impending crisis in the decline of family physicians providing maternity care

In their article, “Proportion of Family Physicians Providing Maternity Care Continues to Decline,” Tong et al1 outlined that the proportion of US family physicians who report providing maternity care declined from 23.3% in 2000 to 9.7% in 2010. This decline has major health care implications because there is growing evidence that the adequacy of prenatal care for women in rural and medically underserved areas is deteriorating.2 The Association of American Medical Colleges estimated that the nation would have a shortage of approximately 21,000 primary care physicians in 2015. Without action, experts project a continued primary care shortage because of the needs of an aging population and the decline in the number of medical students choosing primary care.3 In addition, the American Congress of Obstetricians and Gynecologists, projects a shortage of obstetricians/gynecologists at 25% by 2030 and 35% by 2050.4 These projected shortages will disproportionately affect maternity patients in rural, semirural, and medically disenfranchised areas of major US cities. The Affordable Care Act, which will be enacted in 2014, acknowledges primary care as the backbone of preventive health care and that the provision of a strong primary care workforce is essential to the health of the US population, particularly with its emphasis on the necessity of the medical home.