BOX 13-1Obstetrics and Gynecology Workforce Data

The American College of Obstetricians and Gynecologists (ACOG) has slightly more than 49,000 members, of whom more than 31,000 are practicing in the United States (personal communication, R. Hale, 2005). Of that number, 44 percent are women. An additional 1,500 osteopathic obstetricians and gynecologists practice obstetrics. Urban and suburban areas tend to have the highest concentrations of obstetricians and gynecologists; it is rare for areas with populations of less than 10,000 to have an obstetrician-gynecologist. In those areas family physicians tend to be the obstetricians, although their numbers are dropping rapidly because of the cost of liability Insurance. Approximately 1,100 residents in obstetrics and gynecology complete their training each year. Of this number slightly more than 10 percent go into subspecialty training. Of those who pursue subspecialty training, approximately 30 percent choose maternalfetal medicine, 25 percent select oncology, 30 percent enter reproductive medicine, and 20 percent select urology-gynecology. The actual numbers vary from year to year, depending on position availability (personal communication, R. Hale, 2005). As of September 2005, there were 1,165 fourth-year residents in obstetrics and gynecology. Seventy-six percent of these fourth-year residents were female (personal communication, A. Strunk, January 10 and January 12, 2006).

Data from ACOG professional liability surveys indicate that in 2003, 22 percent of ACOG members decreased the amount of high-risk obstetric care that they offer, 9.2 percent decreased the number of deliveries, and 14 percent stopped practicing obstetrics altogether because of liability claims or litigation. This compares to respective proportions of 18.7, 6.3, and 8.9 percent of physicians providing affirmative responses to these questions in 1996. Because of the reduced affordability and the lack of availability of liability insurance, in 2003 25.2 percent of ACOG members reported that they decreased the amount of high-risk obstetric care that they provided, 12.2 percent reported that they decreased the number of deliveries, and 9.2 percent reported that they stopped practicing obstetrics altogether. The national response rates for the survey were 44 percent in 1996 and 45.45 percent in 2003 (personal communication, A. Strunk, January 10 and January 12, 2006).

From: 13, Barriers to Clinical Research on Preterm Birth and Outcomes for Preterm Infants

Cover of Preterm Birth
Preterm Birth: Causes, Consequences, and Prevention.
Institute of Medicine (US) Committee on Understanding Premature Birth and Assuring Healthy Outcomes; Behrman RE, Butler AS, editors.
Washington (DC): National Academies Press (US); 2007.
Copyright © 2007, National Academy of Sciences.

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