Sabtu, 04 Mei 2019

Will You be Able to Find an OB/GYN When You Need One?

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By 2020, there will be a major US shortage of OB/GYNs.
Currently, women in Philadelphia wait up to an average of 51 days for a new patient appointment with an OB/GYN1. The Affordable Care Act has caused some additional increase in the wait times as more individuals are able to seek care; however, the shortage of primary care physicians has been evident for many years now. ACOG estimates that by 2020, there will be 8,000 less OB/GYNs than needed2. Having a shortage of OB/GYNs puts women, especially those in more rural areas, at a huge risk. This means less access to prenatal care and preventative health screenings, as well as, a larger dependence on nurse practitioners and midwives.


Two of the biggest causes of this problem are physician burn-out leading to early retirement and residency shortages3. So, what is burnout? Burnout is a combination of lack of enthusiasm for work, skepticism, distrust, and low sense of personal accomplishment. This can be due to long work hours, lower than desired pay, lack of control over work situations and lack of support within the work environment. OB/GYN is a field with long, unpredictable hours, many medical liability lawsuits, and high stakes decision making. This can quickly lead to burnout over a short period of time4.


There are 241 OB/GYN residency programs which translates into 1,288 resident spots5. There has been little change to the number of residency programs/spots since the 1997 Balanced Budgeting Act which capped federal funding of medical residency programs. The limited amount of residency spots for OB/GYN continues to worsen the shortage of OB/GYNs available to women, as well as, adds to the physician burnout by causing additional stress to the providers we do have. Approximately 47% of physicians remain in the area where they completed residency training6. The residency programs for OB/GYN are primarily in hospitals in more urban regions. The location of OB/GYN residency programs adds to the lack of OB/GYNs within rural areas, where half of the women must travel over 30 minutes to the nearest hospital with OB/GYN services in the region7.


As, a fourth-year medical student hoping to match into OB/GYN this Spring, I find this information disheartening. I hope we can find ways to rectify this problem soon to assure all women have access to female reproductive health care services.
Victoria Martino, MS4, Women’s Health Pathway


Resources
1https://www.merritthawkins.com/uploadedFiles/MerrittHawkins/Pdf/mha2017waittimesurveyPDF.pdf
2https://www.acog.org/Clinical-Guidance-and-Publications/The-Ob-Gyn-Workforce/The-Obstetrician-Gynecologist-
Workforce-in-the-United-States
3https://www.documentcloud.org/documents/3897592-Doximity-Report-OB-GYN-Workload-and-Potential.html
4http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/news/why-are-obgyns-burning-out?page=0,0
5http://www.nrmp.org/wp-content/uploads/2017/06/Main-Match-Results-and-Data-2017.pdf
6 https://members.aamc.org/eweb/upload/2015StateDataBook%20(revised).pdf
7 https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Health-Care-for-
Underserved-Women/Health-Disparities-in-Rural-Women
https://medicalschoolhq.net/ss-27-a-deep-dive-into-obgyn-residency-match-data/




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