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. 2008 Jan-Feb;6 Suppl 1(Suppl 1):S5-11.
doi: 10.1370/afm.737.

Influence of obstetric practice on workload and practice patterns of family physicians and obstetrician-gynecologists

Graham M Dresden  1 , Laura-Mae Baldwin, C Holly A Andrilla, Susan M Skillman, Thomas J Benedetti
Affiliations

Influence of obstetric practice on workload and practice patterns of family physicians and obstetrician-gynecologists

Graham M Dresden et al. Ann Fam Med. 2008 Jan-Feb.

Abstract

Purpose: Obstetric practice among family physicians has declined in recent years. This study compared the practice patterns of family physicians and obstetrician-gynecologists with and without obstetric practices to provide objective information on one potential reason for this decline--the impact of obstetrics on physician lifestyle.

Methods: In 2004, we surveyed all obstetrician-gynecologists, all rural family physicians, and a random sample of urban family physicians identified from professional association lists (N =2,564) about demographics, practice characteristics, and obstetric practices.

Results: A total of 1,197 physicians (46.7%) overall responded to the survey (41.5% of urban family physicians, 54.7% of rural family physicians, and 55.0% of obstetrician-gynecologists). After exclusions, 991 were included in the final data set. Twenty-seven percent of urban family physicians, 46% of rural family physicians, and 79% of obstetrician-gynecologists practiced obstetrics. The mean number of total professional hours worked per week was greater with obstetric practice than without for rural family physicians (55.4 vs 50.2, P=.005) and for obstetrician-gynecologists (58.3 vs 43.5, P = .000), but not for urban family physicians (47.8 vs 49.5, P = .27). For all 3 groups, physicians practicing obstetrics were more likely to provide inpatient care and take call than physicians not practicing obstetrics. Large proportions of family physicians, but not obstetrician-gynecologists, took their own call for obstetrics. Concerns about the litigation environment and personal issues were the most frequent reasons for stopping obstetric practice.

Conclusions: Practicing obstetrics is associated with an increased workload for family physicians. Organizing practices to decrease the impact on lifestyle may support family physicians in practicing obstetrics.

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References

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