Doximity's 2019 OB-GYN Workforce Study analyzed the primary factors impacting the specialty on a national and local level, including the percentage of OB-GYNs nearing retirement age, the number of younger practicing OB-GYNs, and maternity workloads. By combining these factors, Doximity researchers created a composite index score to identify the U.S. metros that have the highest risk of OB-GYN shortages.
The new report also examined sources of insurance coverage for live births - private vs. government - to help assess whether compensation is proportionate to growing workloads.
The following MSAs are the top 10 most likely to suffer a shortage of OB-GYNs in coming years
Salt Lake City
New to the report this year, Doximity also examined the sharply declining birthrates in the U.S., as published by the Centers for Disease Control and Prevention (CDC). In 2018, the U.S. birthrate fell to the lowest number in 32 years, but the drop was particularly pronounced for millennial women. In 2017, the total fertility rate was 1,764.5 births per 1,000 women. That represents the largest single-year decline since 2010.
Lingering financial challenges from the Great Recession combined with a shortage of trained OB-GYN specialists may make the goal of having children even harder to reach for millennial women.
The projected OB-GYN shortages across the nation pose serious concerns for women's reproductive care. This is particularly concerning for millennials, who are already waiting longer to start a family due to a variety of economic and social factors. Older women are at greater risk of complications during pregnancy, which requires more than average visits with an OB-GYN, said Amit Phull, M.D. Vice President of Strategy and Insights at Doximity.
Additional findings include
1. Startling number of OB-GYNs nearing retirement amidst a serious shortage of younger doctors. A large portion of the OB-GYN population is approaching the average age of retirement in many areas of the country. At the same time, none of the metros studied in the report have at least 30 percent of their workforce under the age of 40.
The metro areas with the highest percentage of OB-GYNs who are 55 years old or above are Pittsburgh (41); Las Vegas (41); Salt Lake City (40); Virginia Beach, V.A. (39); and New Haven, Conn. (39)
The metro areas with the lowest percentage of OB-GYNs younger than 40 are Bridgeport, Conn. (13); Detroit (14); Las Vegas (14); Miami (15); and Buffalo, N.Y. (16)
2. OB-GYN workloads remain high Despite declining birthrates, OB-GYN workloads remain high. Doximity compared the number of live births with the total number of OB-GYN's in the top 50 MSAs.
The metro areas with the largest number of births per OB-GYN are Riverside, Calif.; Las Vegas; St. Louis; Phoenix; and Dallas
The metro areas with the lowest OB-GYN workload are Hartford, Conn.; Bridgeport, Conn.; San Jose, Calif.; New Haven, Conn.; and Portland, Ore.
3. Birthrates are dropping Of the metros Doximity observed in this study, 42 experienced a declining birth rate, and in most cities, the birthrate among millennials has fallen the most. Many of those same metros are also among the most expensive areas to have a baby - with and without insurance.
The metro areas with the largest decline in birth rates are Houston; Portland, Ore.; Salt Lake City; Los Angeles; San Jose, Calif.;
The metro areas with a slightly growing or stagnant birth rate are Nashville, Tenn.; Orlando, Fla.; Louisville, Ky.; Atlanta; and Cincinnati
OB-GYNs provide critical medical services for women throughout their lives. We hope these findings will help healthcare leaders identify ways to address and mitigate potential shortages at regional and national levels, said Chris Whaley, Ph.D., lead author and adjunct assistant professor at the University of California, Berkeley School of Public Health.