Comparisons between Family Medicine and Ob-Gyn
36
Comparisons between Family Medicine and Ob-Gyn William F. Rayburn MD, MBA Professor and Chair, Dept. of Obstetrics & Gynecology University of New Mexico Consultant, Workforce Studies and Planning American Congress of Obstetricians & Gynecologists Anticipated Shortages of Physicians
description
Anticipated Shortages of Physicians. Comparisons between Family Medicine and Ob-Gyn. William F. Rayburn MD, MBA Professor and Chair, Dept. of Obstetrics & Gynecology University of New Mexico. Consultant, Workforce Studies and Planning American Congress of Obstetricians & Gynecologists. - PowerPoint PPT Presentation
Transcript of Comparisons between Family Medicine and Ob-Gyn
Comparisons betweenFamily Medicine and Ob-Gyn
William F. Rayburn MD, MBA
Professor and Chair, Dept. of Obstetrics & GynecologyUniversity of New Mexico
Consultant, Workforce Studies and PlanningAmerican Congress of Obstetricians & Gynecologists
Anticipated Shortages of Physicians
Objectives
After today’s session, the participant will gain more knowledge in comparing between family medicine and general ob-gyn for: Pursuit of residencies Resident demographics Residency graduates Demographics of practitioners Access to care Consequences of shortages
American College of Surgeons
General surgery Obstetrics and gynecology Orthopedics Otolaryngology Opthalmology Neurosurgery Urology Plastic surgery
Data SetsAAMCAssociation of American Medical Colleges
ACOGAmerican College of Obstetricians and Gynecologists
AHAAmerican Hospital Association
Merritt Hawkins Search Firm
NRMPNational Resident Matching Program
U.S. Census Bureau
Percent U.S. Medical Graduates and Specialty Salary
AAMC
Residency Programs, 2011
Programs Positions
Family medicine 453 2,708
General surgery 296 1,179
Ob-gyn 237 1,205
NRMP
Ob-Gyn Residents and Programs
NRMP
Female Residents in Accredited Programs
Average 46.0%
Family medicine 55.6%
Ob-gyn 79.7%
General surgery 35.0%
NRMP
African American, American Indian or Alaska Native, or Native Hawaiian or Pacific Islander Residents in Accredited Programs
Average 6.3%
Family medicine 8.0%
Ob-gyn 11.2%
General surgery 7.2%
NRMP
Hispanic Residents in Accredited Programs
Average 8.0%
Family medicine 9.7%
Ob-gyn 9.0%
General surgery 8.3%
NRMP
Abdominal hysterectomyVaginal hysterectomyLaparoscopic hysterectomyTreatment of incontinence/pelvic floor repairLaparoscopyOperative hysterectomyAbortionTreatment on invasive cancer
Gyn Procedures Performed by Residents
ACOG
Active Physicians Practicing in Same State as Residency Training
Average 47.4%
Family medicine 55.6%
Ob-gyn 47.4%
General surgery 44.4%
AAMC
Trends in Graduates from Residency Programs in Ob-Gyn
Year Graduates (N)
U.S. Population (100,000)
Graduates per 100,000
Population (n)
1995 1,248 2,670 4.7
2000 1,234 2,820 4.4
2005 1,107 2,960 3.7
2010 1,168 3,100 3.8
AAMC
Patients in the General PopulationPer Active Physician
Internal medicine 2,875
Family medicine 2,919
Pediatrics 5,579
Ob-Gyn 7,600
Psychiatry 7,661
Specialties With the Largest Numbers of Active Physicians
Internal medicine 104,904
Family medicine 103,315
Pediatrics 54,061
Ob-Gyn 39,689
Psychiatry 39,371
None 0.1 to 1.0 1.1 to 2.0 2.1 to 3.0 3.1 to 4.0 4.1 or more
per 10,000 women
ACOG
per 10,000 women
Densities of Ob-Gyns
per 10,000 women
ACOG
Active Female Physicians by Medical Specialty, 2007
Average 28.3%
Family medicine 31.3%
Ob-gyn 43.2%
General surgery 13.6%
AAMC
Average Age at Which FellowsStop Practicing Obstetrics
Year All Fellows (Years)
Males (Years)
Females (Years)
1985 49.4 No data No data1987 49.3 No data No data1990 49.8 No data No data1992 48.9 50.2 39.51996 46.6 48.4 39.21999 48.2 51.2 40.82003 48.0 51.0 42.02006 48.0 51.7 43.12009 48.0 51.9 43.8
ACOG
Hospitals with Maternity Services
AHA
Hospitals with Maternity Services60-Minute Drive
AHAUSCB
Hospitals with Maternity Services30-Minute Drive
AHAUSCB
Mean Ages of Male/Female Fellows at ACOG
ACOG
Age Intervals of the Fellows of ACOG
ACOG
Active Physicians Aged 55 Years or Older Categorized by Medical Specialty, 2007
Average 37.6%
Family medicine 36.7%
Ob-gyn 38.5%
General surgery 42.4%
AAMC
Change in Number of Active Physicians1996-2006
General surgery -1.0%
Ob-gyn 10.2%
Family medicine 33.0%
AAMC
Physician Revenue by Payment Source
Medical Specialty Medicare (%)
Medicaid (%)
Insurance (%)
Self-pay (%)
Other (%)
All physicians 29 12 43 12 4
Family practice 23 12 44 17 4
Surgery 35 8 43 12 2Obstetrics and gynecology 11 20 54 13 2
MH
Topics Assessed at a Typical Women’s Annual Visit
Cervical cytologyBreast examinationPelvic examinationAlcohol, tobacco, or drug useSexuality concernsFitness and nutritionPsychologic well-beingCardiovascular risk factorsImmunizations
ACOG
Year Shortest Time
Longest Time
Average Time
Accepting Medicaid (%)
2004
2009
3.0 days
2.5 days
65.1 days
98.7 days
23.3 days
27.5 days
60
41
15 cities, 17 offices per city
Wait Times Before Next Well-Woman Gynecologic Examination
MH
Ten Most Sought After Physicians
1. Family practice 2. Internal medicine 3. Hospitalist 4. Radiology 5. Orthopedic surgery 6. Obstetrics and gynecology 7. Cardiology 8. General surgery 9. Emergency medicine10. Psychiatry
MH
ACOG
Advanced Ob-Gyn Training
Maternal-Child health fellowship
Women’s Health training in internal medicine
Re-entry of Ob-Gyns in the workforce
Nonphysician Practitioners
Types of Nonphysician Practitioners
Training Programs in the United States (N)
EstimatedNonphysician
Practitioners (N)
Certified nurse-midwives 38 11,546
Nurse practitioners 350 135,000
Physician assistants 140 85,345
ACOG
Visits to Retail Clinics
URI, sinusitis 32%Immunizations 24%Pharyngitis 16%Otitis 8%UTI 5%Conjunctivitis 4%BP check 2%Other 10%
Claims: National Ambulatory Medical Care Survey National Hospital Ambulatory Medical Care Survey, 2007
