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Story summary
- The United States is projected to have a shortage of 5,000 obstetricians and gynecologists by 2030.
- As a result, already overworked doctors will struggle even more to meet demand, and health disparities between mothers and children are expected to continue to widen.
- An aging workforce, an aging population, higher rates of burnout, and restrictions on abortion are all contributing to the shortage.
The United States is facing a shortage of obstetricians and gynecologists, and the shortage is expected to worsen in the future.
In 2018, there were about 50,800 obstetricians and gynecologists working in the United States, already too few to meet the growing demand domestically.
Federal officials predict in a 2021 Department of Health and Human Services report that by 2030 there will be about 3,000 fewer obstetricians and gynecologists in the country, while the need for doctors will continue to grow.
Some of the reasons for this shortage, such as the aging of the physician workforce, are similar to the causes of the national healthcare worker shortage. But some, like the Supreme Court’s Dobbs v. Jackson Women’s Health Organization decision, are specialty-specific.
Part of the reason the number of doctors is falling short of demand is because older doctors are retiring and leaving the workforce faster than younger doctors can replace them.
According to the American Medical Association, nearly half of the nation’s practicing physicians are over the age of 55. And a significant portion (35%) will reach retirement age within the next five years.
Stella Dantas, president-elect of the American College of Obstetricians and Gynecologists, said older doctors aren’t working as long as they used to.
“My mother is a doctor who still sees patients in her 70s,” she told The Hill. “We’re not in that generation now.” In fact, doctors are more likely to retire in their mid-60s, Dantas added.
High rates of physician burnout are also contributing to the country’s physician shortage, and obstetrics and gynecology is no exception.
Physicians’ increased administrative duties compared to past generations also contribute to this problem.
“There are a lot of regulatory things that we have to do during work hours that are not necessarily within our scope,” Dantas said.
All doctors, including obstetricians and gynecologists, now spend their days not only examining patients, diagnosing symptoms, and delivering babies, but also filling out, signing, and sending out mountains of paperwork.
This, combined with the struggle to obtain reimbursement for services from health insurance providers such as Medicare and Medicaid, creates the perfect environment for burnout.
In addition to this, obstetricians and gynecologists are also dealing with the stress of increased litigation and malpractice insurance.
According to Medscape’s Physicians and Medical Malpractice Report published last year, obstetricians and gynecologists are the second most litigated physicians in the country, resulting in prohibitively high malpractice insurance premiums. .
In states like Florida, Illinois, and New York, obstetricians and gynecologists pay more than $170,000 a year in malpractice insurance premiums alone, according to NerdWallet.
“Obstetrics is always challenged with work hours and responsibility issues, so we’re seeing people leave the obstetrics part of their practice a little early and do what’s called a gynecology-only practice,” Dantas said.
In other words, doctors are choosing not to treat pregnant people or help them deliver their babies.
Another factor contributing to the shortage of obstetricians and gynecologists is the changing legislative environment, which changed significantly as a result of the Supreme Court’s 2022 Dobbs decision overturning federal protections for abortion, Dantas said.
According to KFF’s 2023 National Obstetrics and Gynecology Survey, most obstetricians and gynecologists did not provide abortion services prior to the ruling, and this has remained the case in the years since.
Before 2022, about 20 percent of obstetricians and gynecologists offered all types of abortion services in their offices. This number fell to 18% last year.
However, the Supreme Court’s decision appears to be having an impact on medical students’ interest in the specialty. Data from the National Resident Match Program shows that about 2 percent fewer senior medical students aiming to become MD or osteopathic physicians applied for obstetrics and gynecology training in 2023 compared to 2022. I am.
According to a study by the American Medical Association, applications to obstetrics and gynecology training programs decreased significantly in the 13 states that enacted outright abortion bans after the Dobbs decision.
Research also shows that abortion restrictions influence where medical students choose to pursue their training programs.
About 77% of third- and fourth-year medical students who participated in the 2023 survey said Dobbs’ decision would influence where they consider their residency applications.
Study co-author Arianna Traub, a medical student at Emory University School of Medicine, said many medical students are concerned that they won’t receive adequate reproductive health education in training programs in states where abortion is prohibited. It is said that
“The idea of practicing medicine in a state with laws prohibiting evidence-based medicine is a difficult pill to swallow early in your career,” Traub said in an email to The Hill.
Traub added that many of the states that have passed complete bans on abortion have the highest maternal and infant mortality rates and wide disparities in access to reproductive health care.
“With increased regulation and the potential for an exodus of obstetricians and gynecologists to less regulated states, this disparity is likely to widen further, leaving the most vulnerable populations further behind,” Traub said. said.
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