Workload rising for declining number of OB-GYNs willing to deliver babies

23/02/2004

Many obstetrician-gynecologists (OB-GYNs) got out of the business of delivering babies over the last decade, leaving a heavier workload for their colleagues, a new study from the Institute for Clinical Evaluative Sciences (ICES) shows.

Study authors Dr. Ben Chan and Dr. Janice Willett examined the impact of age, gender, practice location, and years of practice on the decision of OB-GYNs to practice obstetrics.

Results:

The percentage of OB-GYNs delivering babies dropped from 82% in 1993 to 77% in 2002.
The decline in obstetrical participation meant a 5.6% increase in the annual number of deliveries per physician among those performing deliveries.
Obstetrics participation declined with age – 96% of OB-GYNs under 35 years of age practice obstetrics vs. only 34% of those over age 64.
After accounting for differences in age, female obstetricians were less likely than males to provide obstetrics.
Obstetrics providers had almost double the annual billings of non-providers ($364,000 vs. $187,000), but more on-call days worked (105 vs. 13).
The likelihood of an OB-GYN who has left obstetrics returning to obstetrics was only 1.1% per year.

Implications:

“What we’re seeing here is partially related to the changing demographics and attitudes of the physician pool,” said Dr. Chan. “As more women enter the specialty and as there is more emphasis on work and life balance in general by all physicians, fewer of them wish to continue with the rigorous on-call schedule of obstetrics.”

“Our study has revealed some important trends that policy-makers need to be aware of in order to adequately plan for future obstetrical requirements in Ontario,” said Dr. Chan. “Although midwives will increasingly play an important role in the delivery of routine obstetrical care, there still needs to be a sufficient number of obstetricians to deal with the more complex cases.”

The study, “Factors influencing participation in obstetrics by obstetrician-gynecologists”, is in the current issue of the journal Obstetrics & Gynecology.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measure of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners and practitioners to make decisions about care delivery and to develop policy.