Volume 199, Issue 1 , Pages 88.e1-88.e8, July 2008
Outlook for the future of the obstetrician-gynecologist workforce
Article Outline
Objective
The objective of the study was to assess the future physician workforce with a sample of obstetrician-gynecologists.
Study Design
Two separate surveys regarding career satisfaction and retirement plans were sent to random samples of obstetrician-gynecologists under age 50 years (n = 2,000) and over the age of 50 (n = 2,100).
Results
Obstetrician-gynecologists over the age of 50 years who were working part time or were female were more satisfied than those working full time or were male. Obstetrician-gynecologists (under and over age 50 years) who were concerned about liability and unable to balance their work and personal lives were more dissatisfied. Obstetrician-gynecologists retired earlier than planned because of rising malpractice costs and later than planned because of high career satisfaction.
Conclusion
Low career satisfaction may be adding to the already shrinking physician workforce. Offering part-time work opportunities and alleviating liability concerns may increase career satisfaction and help to combat a future of the physician workforce shortage.
Key words: obstetrician-gynecologists, malpractice, part-time, satisfaction, retirement
Since 2005 a dozen states and more than 15 specialties have reported a physician shortage or anticipate one in the next few years.1 These shortages are due in part to a growing number of patients older than 65 years (the age group that requires the most health care) and an aging physician population.2 Nonexpanding MD enrollment,2 an increasing interest in reduced work hours,3, 4, 5 and career dissatisfaction6 also contribute to the physician shortage.
For Editors' Commentary, see Table of Contents
Dissatisfaction with medicine as a career is associated with burnout7, 8, 9 and the desire to retire early.6 Dissatisfied physicians have been found to be 2-3 times more likely to leave medicine than satisfied physicians.10 The number of physicians who are dissatisfied with medicine as a career is increasing, and as a result, there is increasing concern for an already shrinking physician workforce.11, 12
More so than other specialties, obstetrics and gynecology is particularly vulnerable to experience a shortage. First, the obstetrician-gynecologist workforce is aging; 35% of obstetrician-gynecologists in practice are over the age of 50 years.13 Second, studies show that obstetrician-gynecologists consistently rank as 1 of the most dissatisfied specialties in medicine.6, 14 High levels of dissatisfaction, caused in part by increased liability, are thought to be a major factor in early retirement of obstetrician-gynecologists.15 Third, fewer US students are interested in specializing in obstetrics or gynecology than in years past.16, 17 Overall match rates in the United States are higher than ever; however, this is largely due to the international medical graduate: only 72.5% of positions were filled with US medical school seniors in 2007, compared with 86.3% in 1997.17
In this study, we examined whether career satisfaction is related to part-time work and increasing liability and also current retirement plans and concerns. Using responses from obstetrician-gynecologists in all stages of practice (from their first year to after retirement), we assessed the future physician workforce.
Materials and Methods
Survey and sample
Two surveys were administered by the Association of American Medical Colleges (AAMC) in collaboration with the American College of Obstetricians and Gynecologists. The names and addresses of the eligible physicians were obtained from the American Medical Association.
Two different, but somewhat similar, surveys were administered, 1 to physicians younger than age of 50 years and the other to physicians older than age of 50 years. The physicians younger than age of 50 years were given a 42 question survey about practice activity, career satisfaction, and work preferences. Between February and May 2006, the AAMC sent out 2 mailings to physicians with a $2 bill enclosed in the first mailing. The physicians older than age of 50 years were given a 38 question survey about current practice activity, career satisfaction, and retirement plans. Again, 2 mailings were sent out from the AAMC during February to May 2006 with a $2 bill included in the first mailing.
The American College of Obstetricians and Gynecologists obtained the survey responses from AAMC to analyze for this report.
Data analysis
Because sex and age were correlated in the samples of physicians younger than age 50 years and physicians over the age of 50 years, sex analyses were done controlling for age. The survey for physicians over the age of 50 years was also analyzed for group differences based on practice status (practicing vs retired). Practicing obstetrician-gynecologists were those who reported they were practicing full-time, practicing part-time, and temporarily inactive. Retired obstetrician-gynecologists were those who reported being fully retired.
A satisfaction scale was created for both surveys using 3 questions relating to career satisfaction. Responses for both surveys were given on a 5 point scale: very dissatisfied (1), somewhat dissatisfied, neutral, somewhat satisfied, and very satisfied (5). Physicians under the age of 50 years were asked, “How would you rate your satisfaction with the following?”: your career in medicine, your specialty, and your job/position. Physicians over the age of 50 years were asked, “How satisfied or dissatisfied are you with each of the following?”: medicine as a career, your specialty/subspecialty, and your current position.
Data were analyzed using a personal computer–based version of SPSS 15.0 (SPSS Inc, Chicago, IL). Data from the survey to physicians over the age of 50 years and the survey to physicians under the age of 50 years were analyzed separately. Descriptive and frequency data were computed for primary analysis. Group differences were analyzed using χ2, 1-way analysis of variance (ANOVA), and univariate ANOVA when controlling for covariates (analysis of covariance). Correlations were measured using Pearson correlation. Significance was evaluated at alpha < 0.05 and confidence intervals of 95%.
Results
Demographics
Of the 2000 surveys that were sent to obstetrician-gynecologists under the age of 50 years (U50s), 807 were returned for a 40.3% response rate. The U50 demographics are presented in Table 1. Mean birth year was 1964 (SD 5.1). U50 respondents were predominantly female (52.9%), white (77.7%), married (86.5%), and had graduated with an MD (93.1%). Males were slightly, but significantly, older than females (male M = 1963, SD 4.9; female M = 1965, SD 5.1; F [1, 715] = 19.40, P < .001). Female U50s were more likely to work part-time than male U50 (r = 23.9, P < .001 when controlling for age), with 10.6% of practicing females and 1.4% of practicing males working part-time.
TABLE 1. Demographics of obstetrician-gynecologists under the age of 50 years
| Total (n = 807), % or M (SD) | |
|---|---|
| Year of birth | 1964 (5.1) |
| Sex | |
| Male (n = 298) | 36.93 |
| Female (n = 427) | 52.91 |
| Not given (n = 82) | 10.16 |
| Race (participants asked to mark all that apply) | |
| White (n = 627) | 77.70 |
| Black/African American (n = 49) | 6.10 |
| Asian or Pacific Islander (n = 46) | 5.70 |
| Asian Indian or Pakistani (n = 38) | 4.70 |
| Native American/Alaskan (n = 1) | 0.10 |
| Other (n = 40) | 5.07 |
| Hispanic origin | |
| Yes (n = 48) | 5.95 |
| No (n = 749) | 92.81 |
| Not given (n = 10) | 1.24 |
| Marital status | |
| Single, divorced or widowed (n = 99) | 12.27 |
| Married or married-like status (n = 698) | 86.49 |
| Not given (n = 10) | 1.24 |
| Practice type | |
| Full-time (n = 728) | 90.21 |
| Part-time (n = 57) | 7.06 |
| Temporarily inactive (n = 15) | 1.86 |
| Permanently inactive (n = 4) | 0.50 |
| Not given (n = 3) | 0.37 |
| Principle work setting | |
| Group practice/partnership (n = 466) | 57.74 |
| Solo practice (n = 127) | 15.74 |
| Teaching hospital (n = 104) | 12.89 |
| HMO/managed care organization (n = 21) | 2.60 |
| Federal government (n = 14) | 1.73 |
| Medical school (n = 13) | 1.61 |
| Nonteaching hospital (n = 11) | 1.36 |
| State or local government (n = 7) | 0.87 |
| Ambulatory clinic/urgent care/surgical center (n = 6) | 0.74 |
| Other (n = 11) | 1.36 |
| Not given (n = 27) | 3.36 |
| Group practice | |
| Single specialty (n = 423) | 52.42 |
| Multiple-specialty practice (n = 103) | 12.76 |
| Not in group practice (n = 281) | 34.82 |
| Undergraduate education | |
| MD (n = 751) | 93.06 |
| DO (n = 39) | 4.83 |
| MBBS/MBChB (n = 10) | 1.24 |
| Not given (n = 7) | 0.87 |
Of the 2100 surveys that were sent to obstetrician-gynecologists aged 50 years old and older (O50s), 1204 were returned for a 57.3% response rate. The O50 demographics are presented in Table 2. Mean birth year was 1943 (SD 8.0). O50 respondents were predominantly male (71.0%), white (81.3%), married (80.0%), and had graduated with an MD (92.5%). Males were significantly older than females (male M = 1943, SD 8.0; female M = 1948, SD 6.5; F [1, 915] = 53.5, P < .001). Mean age of retired O50s was 62.8 years (SD 6.5).
TABLE 2. Demographics of obstetrician-gynecologists over the age of 50 years
| Total (n = 1204), % or M (SD) | |
|---|---|
| Year of birth | 1943(8.0) |
| Sex | |
| Females (188) | 15.62 |
| Males (855) | 71.01 |
| Not given (161) | 13.37 |
| Race (participants asked to mark one) | |
| White (979) | 81.31 |
| Asian or Pacific Islander (101) | 8.39 |
| Black/African American (53) | 4.40 |
| Multiple races (11) | 0.91 |
| Other (33) | 2.74 |
| Not given (27) | 2.25 |
| Hispanic origin | |
| Yes (59) | 4.90 |
| No (1121) | 93.11 |
| Not given (24) | 1.99 |
| Marital status | |
| Married/partner (964) | 80.07 |
| Divorced/separated (79) | 6.56 |
| Widowed (23) | 1.91 |
| Single (30) | 2.49 |
| Not given (108) | 8.97 |
| Practice type | |
| Full-time (699) | 58.06 |
| Part-time (176) | 14.62 |
| Fully retired (289) | 24.00 |
| Temporarily not active in medicine (14) | 1.16 |
| Never active in medicine (1) | 0.08 |
| Not given (25) | 2.08 |
| Principal work setting | |
| Group practice/partnership (369) | 30.65 |
| Solo practice (306) | 25.42 |
| Teaching hospital (67) | 5.56 |
| HMO/managed care organization (31) | 2.57 |
| Medical school (30) | 2.49 |
| Ambulatory clinic/urgent care/surgical center (22) | 1.83 |
| State or local government (14) | 1.16 |
| Nonteaching hospital (10) | 0.83 |
| Federal government (Veterans Affairs, military, etc) (7) | 0.58 |
| Other (15) | 1.25 |
| Not given (333) | 27.66 |
| Undergraduate education | |
| MD (1114) | 92.52 |
| DO (33) | 2.74 |
| MBBS/MBChB (24) | 1.99 |
| Not given (33) | 2.75 |
Patient care
Table 3 shows the percent of time physicians spend in patient care, management, training, and research. Part-time O50s spent a greater percentage of time conducting research (M = 11.0/4.3; F [1,264] = 6.996, P = .009) and teaching/precepting (M = 25.6/10.8; F [1,388] = 39.400, P < .001), whereas full-time O50s spent more time providing patient care (M = 85.6/80.1; F [1, 849] = 7.584, P = .006). In contrast, there was no difference in practice activities between part-time and full-time U50s. Full-time male O50s worked more hours per week than full-time female O50s (males M = 60.8, SD 24.6, females M = 55.9, SD 21.1; F [1,537] = 7.05, P = .008, controlling for age).
TABLE 3. Time spent in patient care, management, training, and research
| Time with patient care (%) | Time in health care management (%) | Time in training (%) | Time in research (%) | |
|---|---|---|---|---|
| Physicians under 50 y | 82.9 | 8.6 | 7.6 | 5.3 |
| Physicians over 50 y | 84.2 | 13.7 | 13.5 | 5.2 |
| Physicians over 50 y by work status | ||||
| Part-time | 80.1 | 17.5 | 25.6 | 11.0 |
| Full-time | 85.6 | 12.8 | 10.8 | 4.3 |
Full-time U50s spent an average of 10.5 (SD 13.6) hours/week seeing hospital in-patients, and part-time U50s spent an average of 6.9 (SD 10.3) hours/week seeing in-patients. Full-time U50s reported an average of 92.3 (SD 49.0) patient visits/encounters per week and part-time U50s reported an average of 57.1 (SD 33.0).
Full-time O50s spent an average of 14.4 (SD 15.2) hours/week seeing hospital in-patients, part-time O50s spent an average of 3.5 (SD 7.9) hours/week seeing in-patients. Practicing O50 males spent more time with hospitalized patients than practicing O50 females each week (males M = 12.9, SD 15.2, females M = 9.9, SD 13.8; F [1, 671] = 9.068, P < .003, controlling for age).
Career satisfaction
Most U50s and O50s (practicing) were satisfied, scoring an average of 11.8 (SD 3.1) and 11.7 (SD 3.3), respectively (3 being the least possible satisfaction score and 15 being the highest possible satisfaction score). There was no significant difference for U50s by sex or age; however, in O50s there were significant differences by sex (F [2, 682] = 17.3, P < .001 when controlling for age) and work status (F [1, 829] = 5.650, P = .018) (see Table 4). Rating of career satisfaction of O50s increased with age (r = .218, P < .001). Ratings of career satisfaction also varied among O50s by practice settings (F [9, 825] = 4.53, P < .001); practicing O50s in solo practice were less satisfied with medicine as a career than practicing 050s in a teaching hospital (P = .005) or a medical school (P < .02).
TABLE 4. Satisfaction scores of physicians under the age 50 and over the age 50
| Physicians under age 50 y Total satisfaction score = 11.8 (SD 3.1) | |||
|---|---|---|---|
| Sex | Work status | ||
| Male | Female | Part-time | Full-time |
| 11.5(3.4) | 11.6(3.4) | 11.5(3.5) | 11.6(3.4) |
| Physicians over age 50 y Total satisfaction score = 11.7 (SD 3.3) | |||
|---|---|---|---|
| Sexa | Work statusb | ||
| Male | Female | Part-time | Full-time |
| 11.5(3.4) | 12.4(2.5) | 12.3(3.5) | 11.6(3.3) |
aP < .001. |
bP < .05. |
The O50 sample was asked how their level or career satisfaction had changed in the past 3 years. Whereas 45.2% were less satisfied, 35.5% reported no change, and only 15.9% of O50s were more satisfied. Male O50s were more likely to be less satisfied than female O50s (F [1, 670] = 16.6, P < .001).
Work–personal life balance
When asked about the ability to work part time, 1 in 4 (25.3%) full-time U50s was interested in part-time hours but did not have the option, and 31.8% were not interested and did not have an option. The remaining full-time U50s who had the option of part-time hours were considering part-time hours for the future (16.9%) or were not interested (25.9%). About 1 in 3 of all practicing full-time O50s was interested in part-time hours but did not have the option (36.7%), and 1 in 5 did not have an option but were not interested in part-time hours (20.5%). The remaining practicing full-time O50s had the option but were not interested in part-time hours (18.7%) or were considering working part-time in the future (24.1%).
When comparing the satisfaction score with the desire to work part-time, U50s who were interested in part-time hours but did not have the option were less satisfied (M = 10.9, SD 3.2) than U50s who had the option but were not interested (M = 12.8, SD 2.6). O50s who did not have the option to work part-time but were interested in part-time hours had lower satisfaction scores (M = 10.6, SD 3.4) than those who had the option, regardless of whether they were currently working part-time (M = 12.3, SD 3.2), considering doing so in the future (M = 12.3, SD 3.0), or not interested in part-time hours (M = 12.3, SD 3.1; F [4, 812] = 9.988, P < .001) (Figure 1).
FIGURE 1.
Satisfaction of obstetrician-gynecologists under and over the age of 50 years and the ability to work part-time
Obstetrician-gynecologists under and over the age of 50 years who would like to work part time but do not have the option are less satisfied than those who are not interested in working part time (regardless of whether they have the option).
Anderson. Outlook for the future of the obstetrician-gynecologist workforce. Am J Obstet Gynecol 2008.
Those U50s currently practicing full-time work 66 hours/week on average (SD 50.7) but would ideally like to work 44 hours/week on average (SD 11.8). Full-time U50s who work 44 hours/week or less were slightly, but significantly, more satisfied with their work schedules (M = 3.7, SD 1.3) than those working more than 44 hours/week (M = 3.1, SD 1.2; F [1, 687] = 25.646, P < .001).
Only 7.6% of U50s strongly agreed that they were able to satisfactorily balance their work and personal lives. U50s who had higher satisfaction scores were more likely to report that they can satisfactorily balance their work and personal lives (F [4,796] = 22.420, P < .001) and are able to control their work hours/schedules (F [4,794] = 15.790, P < .001) (Figure 2). Almost all U50s indicated that time for family/personal pursuits are very important (70.6%) or important (22.2%), and flexible scheduling is very important (32.5%) or important (35.9%) when thinking about a desirable professional practice.
FIGURE 2.
Satisfaction and life balance for obstetrician-gynecologists under the age of 50 years
Obstetrician-gynecologists under the age of 50 years who are better able to balance their work and personal life are more satisfied than those who can not.
Anderson. Outlook for the future of the obstetrician-gynecologist workforce. Am J Obstet Gynecol 2008.
Liability
When thinking about retirement, 84.2% of O50s reported rising malpractice costs as a somewhat important or very important concern. The more important O50s rated rising malpractice costs, the less satisfied they reported being (F [2, 748] = 34.0, P < .001; Figure 3).
FIGURE 3.
Obstetrician-gynecologists satisfaction and the importance of rising malpractice costs when thinking about retirement
Greater concern about rising malpractice costs among obstetrician-gynecologists over the age of 50 years is associated with lower levels of satisfaction.
Anderson. Outlook for the future of the obstetrician-gynecologist workforce. Am J Obstet Gynecol 2008.
Almost all U50s strongly agreed or agreed that the fear of litigation affects their practice of medicine (82.8%) and that the cost of their malpractice insurance is too high (83.7%). Those who were more likely to strongly agree that the cost of their malpractice insurance is too high (M = 11.2, SD 3.4) had lower satisfaction scores than those who strongly disagreed (M = 14.00, SD 1.1; F [4, 769] = 6.686, P < .001). U50s who strongly agreed (M = 10.9, SD 3.3) that their fear of litigation affects their practice of medicine had a lower satisfaction score than U50s who strongly disagreed (M = 13.7, SD 2.0; F [4, 777] = 11.9, P < .001).
Retirement
Although the average age that O50s planned to stop providing patient care was 65.5 years (SD 5), the average age O50s actually stopped providing patient care was 60.33 years (SD 8.9). The average age U50s would like to stop practicing medicine was 58.8 years (SD 7.1). On average, female O50s retired at a younger age (59.3 years, SD 7.3) than male O50s (63.3 years, SD 6.3; F [1, 198] = 8.47, P = .004). The greater the satisfaction score, the older O50s planned to retire (r = .268, P < .001).
Among the retired O50s, most retired earlier than expected (59.2%), some retired about when expected (34.7%), and few retired later than expected (6.1%). Those O50s who retired earlier than planned indicated doing so because of rising malpractice costs (59.5%), insufficient reimbursements (44.8%), and personal health (39.3%) (Figure 4). O50s retired later than planned because of a high career satisfaction (68.8%) and finances (they could not afford to retire, 31.3%).
FIGURE 4.
Reasons that obstetrician-gynecologists over the age of 50 years retired earlier than expected
Rising malpractice premiums was the number 1 reason why obstetrician-gynecologists retired earlier than expected.
Anderson. Outlook for the future of the obstetrician-gynecologist workforce. Am J Obstet Gynecol 2008.
Most O50s reported that career satisfaction (92.0%) and needs of their patients (83.1%) were somewhat important or very important in motivating them to remain active in medicine. More female O50s (74.0% of females) than male O50s (63.0% of males) found career satisfaction to be very important motivation in remaining active in practice (F [1, 832] = 13.7, P < .001, controlling for age). Even though only half of practicing O50s would retire if it was affordable, financial needs or obligations and good income were somewhat important or very important motivators for remaining active in medicine for 85.1% and 84.1% of respondents, respectively. Of O50s (retired and practicing), 72.6% rated availability of part-time work and/or more flexible scheduling as having somewhat of an effect or a significant effect on their willingness to remain active in medicine past their expected retirement age.
Most U50s said that if they could afford to, they would reduce their hours (82.9%) but not leave medicine (62.5%). Those U50s who would leave medicine had a lower satisfaction score (M = 9.6, SD 3.6) than those who would not leave medicine (M = 12.4, SD 3.3; F [1, 782] = 115.7, P < .001). In the O50 sample, 42.0% would retire today if it was financially viable, with younger obstetrician-gynecologists being more likely to want to retire than older obstetrician-gynecologists (F [3,994] = 137.3, P < .001).
The more satisfied the practicing O50s reported being, the less likely they were willing to retire today if they could afford to (F [1, 720] = 247.4, P < .001).
Comment
Consistent with previous research,2, 10, 12 our results suggest that the obstetrician-gynecologist specialty faces a potential workforce shortage. A reduced accessibility to women's health care is likely not only because of the increasing demand for medical services and aging physician population but also, as our study suggests, because dissatisfied obstetrician-gynecologists are more likely to retire early and new obstetrician-gynecologists work fewer hours than obstetrician-gynecologists in the past.
A major change in the obstetrician-gynecologist specialty is gender distribution of obstetrician-gynecologists. More than 75% of obstetrician-gynecologist residents are now female.18 Significantly, females under the age of 50 years in our study were more likely to work part-time than males under the age of 50 years. With an increasing number of females entering the obstetrician-gynecologist specialty, our results suggest that there will be greater interest in part-time hours.
Providing part-time hours for obstetrician-gynecologists near retirement is more likely to help than harm the physician workforce. Not only were part-time obstetrician-gynecologists over the age of 50 years more satisfied than full-time obstetrician-gynecologists over the age of 50 years, but those who had the option to work part-time, regardless of whether they wanted part-time work, were more satisfied than those who do not. Furthermore, more than two thirds of obstetrician-gynecologists over the age of 50 years reported that part-time options affect their desire to remain active in medicine and 2 of 3 obstetrician-gynecologists retired later than planned because of high career satisfaction. Together these results suggest that offering part-time opportunities for older obstetrician-gynecologists, may increase the satisfaction of obstetrician-gynecologists over the age of 50 years and help to retain the obstetrician-gynecologist workforce by keeping them interested in working longer.
Concurrent with the desire to work part-time, a more flexible lifestyle is increasingly important to obstetrician-gynecologists19 as well as medical students who are choosing a specialty.16 The introduction of the laborists to the obstetrics specialty demonstrates the ability to create jobs with schedules and incentives that may increase the satisfaction of physicians.20 Obstetrician-gynecologists in our study tended to be more satisfied when they were working closer to their desired number of hours per week and can balance their work and personal lives. Family responsibility was a key factor in the decision to retire early. Although females were more likely to work part-time, males and females rated family/personal pursuits and flexible schedule equally as important.
The increasing number of malpractice suits is having a great impact on the physicians in the obstetric-gynecologic specialty.15, 21, 22 Nearly two thirds of obstetrician-gynecologists over the age of 50 years in our survey reported retiring early, at least in part, because of rising medical malpractice premiums, and rising malpractice costs were a very important consideration when planning for retirement for almost all obstetrician-gynecologists over the age of 50 years.
America is currently experiencing a nationwide shortage of physicians in various specialties.2 Our research suggests that career dissatisfaction is likely contributing to the decreasing physician workforce. Expanding medical education will help to combat this shortage over a long period of time. In the short term, improving career satisfaction and offering part-time options may help to retain physicians who are currently in practice, even those at or near retirement age, as well as improve the quality of care women receive. The results of our study give credence to research and policies that aim to increase the satisfaction of dissatisfied physicians to prevent them from retiring early or leaving medicine. The potential dangers of an obstetrician-gynecologist workforce shortage, further legitimized in this study, warrant serious attention to ensure that the accessibility and quality of women's health care is not compromised in the years to come.
References
- . Recent studies and reports on physician shortages in the US. Available at: http://www.aamc.org/workforce/recentworkforcestudies2007.pdf. Accessed Aug. 13, 2007 Washington (DC): Association of American Medical Colleges; 2007;
- . Physician workforce shortages: Implications and issues for academic health centers and policy makers. Acad Med. 2006;81:782–787
- . Career preferences and the work-family balance in medicine: Gender differences among medical specialists. Soc Sci Med. 2000;50:1235–1246
- . Gender and parenting significantly affect work hours of recent dermatology program graduates. Arch Dermatol. 2004;140:191–196
- . The generation and gender shifts in medicine: An exploratory survey of internal medicine physicians. BMC Health Services Res. 2006;6:55
- . Dissatisfaction with medical practice. N Engl J Med. 2004;350:69–75
- The work lives of women physicians: Results from the physician work life study. J Gen Intern Med. 2000;15:372–380
- . Physician burnout. Ann Intern Med. 2001;135:145–148
- . Predictors of physician career satisfaction, work-life balance, and burnout. Obstet Gynecol. 2007;109:949–955
- Leaving medicine: The consequences of physician dissatisfaction. Med Care. 2006;44:234–242
- . Changes in career satisfaction among primary care and specialist physicians, 1997-2001. JAMA. 2003;289:442–449
- . The downward spiral of physician satisfaction: An attempt to avert a crisis within the medical profession. Obstet Gynecol. 2007;109:1181–1183
- AMA physician specialty data: A chart book. Available at: https://services.aamc.org/Publications/showfile.cfm?file=version67.pdf&prd_id=160&prv_id=190&pdf_id=67. Accessed Aug. 29, 2007 Washington (DC): Association of American Medical Colleges; 2006;
- . Physician career satisfaction across specialties. Arch Intern Med. 2002;162:1577–1584
- . Professional liability and other career pressures: Impact on obstetrician-gynecologists' career satisfaction. Obstet Gynecol. 2004;103:967–973
- . Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA. 2007;290:1173–1178
- . http://www.aafp.org/online/en/home/residents/match/table11.htmlAccessed Nov. 19, 2007
- http://www.aamc.org/members/wim/statistics/stats06/table02.pdfAccessed Aug. 29, 2007
- . Heavier workload, less personal control: Impact of delivery on obstetrician/gynecologists' career satisfaction. Am J Obstet Gynecol. 2004;19:851–857
- . The laborist: A new focus of practice for the obstetrician. Am J Obstet Gynecol. 2003;188:310–312
- . 2003 ACOG economic survey. http://www.acog.org/from_home/departments/practice/ProfileofOb-gynPractice1991-2003.pdfAccessed January 2007
- . ACOG professional liability survey. http://www.acog.org/departments/professionalliability/2006surveyNatl.pdfAccessed January 2007
This study was supported by the Office of Medical Applications of Research, National Institutes of Health, and Grant R60 MC 05674 from the Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services.
Cite this article as: Anderson BL, Hale RW, Salsberg E, et al. Outlook for the future of the obstetrician-gynecologist workforce. Am J Obstet Gynecol 2008;199:88.e1-88.e8.
PII: S0002-9378(08)00277-9
doi:10.1016/j.ajog.2008.03.013
© 2008 Mosby, Inc. All rights reserved.
Volume 199, Issue 1 , Pages 88.e1-88.e8, July 2008
