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We're on the Verge of a Devastating OB-GYN Shortage

A new study identifies which cities will feel it the most.

by Hannah Smothers
Sep 18 2019, 8:16pm

Zackary Drucker/The Gender Spectrum Collection

Women’s healthcare in this country is already, essentially, a haunted house where the exit doesn’t exist and new terrors pop out of the walls randomly. To add another scary feature, a study released this week predicts a nationwide shortage of obstetricians and gynecologists in this country as soon as next year.

Researchers have been issuing ominous warnings of a nationwide shortage of physicians, in general, for several years. But things are particularly bad in OB-GYN, an area of care with increasingly high demand (for childbirth, yes, but also annual exams, STI and cancer screening, prenatal care…), and a high percentage of physicians nearing retirement age. A 2017 study by the American College of Obstetricians and Gynecologists predicted a shortage of 8,800 OB-GYNs by 2020 (so, a few months from now), and warned that, by 2050, the country will be short some 22,000 women’s health physicians.

This new data added to and honed in on those predictions by isolating the cities that will be hit the hardest by a lack of doctors. Researchers used data from doctor profiles on Doximity (basically LinkedIn but for doctors) to determine the average age and number of OB-GYNs practicing in the 50 most-populous cities across the country.

According to the study findings, Las Vegas, Salt Lake City and Miami will face the most dire lack of OB-GYNs. The study also shows drastic differences in demand in places where there’s already not nearly enough obstetricians: In Las Vegas, a physician delivers an average of 165 babies per year, while in Portland, where there’s an abundance of OB-GYNs, the average number of deliveries is about 62. The obvious conclusion you can draw from this is that a doctor’s work-life balance, plus their likelihood to burn out, is extremely dependent on the market for their services in the city where they practice.

Researchers say the increasing disparity between the number of people who need OB-GYN care and the number of working OB-GYNs is caused mostly by population growth. In its 2017 study, ACOG conservatively guessed the demand for OB-GYN services in the country would increase by at least six percent over the decade. But ACOG also notes that OB-GYNs are among the lowest-paid of the surgical subspecialties, have some of the least control over their personal lives, and face higher rates of professional burnout than other specialties. Because of this, OB-GYNs tend to retire a few years earlier than other physicians.

The biggest, self-imposed limitation of this study is that it leaves out rural areas, which are always most affected by any gap in healthcare. By ACOG’s math, nearly half of all U.S. counties lacked a single OB-GYN in 2017. Stack that on top of the shortage of clinics (becoming worse by the day), and being pregnant or needing just any sort of reproductive care in a rural county in the United States sounds inconvenient at best, and totally untenable at worst.

The dressing on this hell-salad is that a strain on access to OB-GYNs means the number of people who can access and afford prenatal care—already something of a pregnancy privilege—will shrink. Not to raise the volume at which I’m already screaming, “THIS IS BAD,” but, according to the CDC and also common sense, early and continuous prenatal care is the best way to prevent pregnancy complications that contribute to this country’s soaring maternal mortality rate.

As this latest study predicts, Millennials (who tend to want children less, but do still have them) are poised to be most affected by the impending lack of OB-GYNs.

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