Effectively Recruiting OB-GYNs to Mitigate Supply and Demand Challenges

Physician shortages are projected to be widespread throughout the United States and will include both primary care physicians and specialists such as OB-GYNs. According to the Association of American Medical Colleges (AAMC), there will be a deficit of up to 124,000 physicians by 2034, including a deficit of up to 48,000 primary care physicians and an even larger deficit of up to 78,000 specialists.

The shortage cuts across specialty lines and includes a deficit of OB-GYNs. The American College of Obstetricians and Gynecologists (ACOG) reports that half of U.S. counties lack a single obstetrician-gynecologist. These areas are home to more than 10 million women, many of whom may need OB-GYNs for primary care. There are up to 8,000 fewer OB-GYNs than needed, according to ACOG, and the number may rise to 22,000 by 2050.

What is driving these increased shortages of OB-GYNs? With many factors contributing to the widespread provider shortages across healthcare, it’s important to pinpoint the specific issues affecting this critical field.

Declining Birthrates and Service Line Closures

OB-GYN shortages exist even though birthrates nationally in the U.S. have declined over the last two decades and some hospitals have closed their labor and delivery service lines. These closures often are tied to an inability to staff OB-GYNs, or the anesthesiologists and certified registered nurse anesthetists needed to perform deliveries. 

The decline in birthrates has not inhibited demand for OG-GYNs for a variety of other reasons, including geographic distribution of OG-GYNs, OB-GYN demographics, and OB-GYN practice patterns.

Aging, Burnout, and Sub-Specialization

Part of the OB-GYN access problem is tied to the fact that the supply of physicians in all specialties is growing slowly, due the cap Congress placed on funding for physician graduate medical education in 1997. The cap was lifted in 2020 as part of the COVID-19 relief bill, but funding was only added for 1,000 residency positions to be created over five-year period.

In addition, many OB-GYNs are nearing retirement: their average age is 51, and they tend to retire beginning at 59, according to the AAMC. Some may consider leaving in part because of their specialty’s high likelihood of being sued.
In fact, Medical Economics reports that 62% of OB-GYNs will face legal action at some point, the highest rate of all specialties. Long hours, midnight dashes to the hospital, and stressful emergencies all contribute to the burnout that can lead OB-GYNs to cut back on, or leave, their practices.

Compounding the shortage is the growing number of OB-GYN residents who pursue subspecialty training. In 2000, only 7% sought subspecialty training, now about one-third do according to ACOG. Below is a snapshot of the current OB-GYN workforce:

     Specialty Demographic: OB-GYN

More Women Physicians, Fewer FTEs

As these numbers indicate, the majority of OB-GYNs in active patient care today are women. Nationally, 82% of medical school graduates matching into OB-GYN residency programs today are women and in ten years women will represent over two-thirds of all active OB-GYNs. A significant number of OB-GYNs (40%) are 55 years old or older, the majority of them male. A wave of retirements can be expected in the specialty with retiring male doctors largely replaced by younger female doctors.

Many patients express a preference for female OB-GYNs, and the influx of women into the specialty has allowed many patients to access female OB-GYNs. However, this has had an inhibiting effect on total FTEs. Women physicians on average work fewer hours than men and see 12% fewer patients, according to the Survey of America’s Physicians conducted by AMN Healthcare/Merritt Hawkins on behalf of The Physicians Foundation

In addition, women tend to have shorter medical careers than do men. According to the University of Michigan’s Intern Health Study, almost 40% of female physicians scale back their practice hours or quit medicine altogether within six years of residency. The study showed 22.6% of women doctors were not working full-time, compared to 3.6% of males, within six years of completing training. 

The gap between men and women physicians expands for those with and without children. The AAMC adds that 30.6% of women doctors with children were not working full-time within six years of residency compared to 4.6% of male doctors with children.

One reason for this is the relatively high rate of burnout among women physicians caused, in part, by their dual responsibilities as professionals and mothers. Studies show that female physicians take on an average of 8.5 hours more work at home each week than do male physicians. Married male doctors with children spend seven hours longer at work and spend 12 hours less per week on parenting or domestic duties than do female doctors.

According to the Survey of America’s Physicians, 78% of physicians sometimes, often or always experience feelings of burnout. The survey also found that the burnout rate is higher for female physicians (84.8%) than it is for male physicians (74.1%).

Recommendations for Effective OB-GYN Recruitment

As demand for OB-GYNs has increased, so has the difficulty of recruiting these specialists. Hospitals, medical groups and other healthcare facilities that are seeking OB-GYNs should prepare to commit the required effort, flexibility, responsiveness and resources required to be successful in today’s challenging market.

Like other physicians, OB-GYNs today put a premium on schedule flexibility, particularly given the fact that so many are women and may have dual professional/child rearing responsibilities. This is obviously a particular challenge in smaller communities with few OB-GYNs available to share call. Utilizing locum tenens physicians to expand coverage can be an option in these situations. If there is no way to address the call schedule it may be necessary to offer financials higher than the average compensation numbers listed above.

The compensation package also may include a significant level of educational loan repayment, an incentive that is somewhat more common in OB-GYN search than in some other specialties. The average educational loan repayment amount for all specialties as tracked in AMN Healthcare’s 2023 Review of Physician and Advanced Practice Recruiting Incentives is $98,665.

A favorable OB-GYN practice opportunity will feature a balance in volume so that OB-GYNs can maintain both their OB and GYN skills without being overwhelmed. Many younger candidates today consider having access to a robot to be a mandatory part of an attractive practice opportunity.

In is important to come to the market with a competitive opportunity rather than coming in low and hoping to negotiate from there. Most OB-GYN candidates are scheduling multiple interviews and virtually all of them are receiving extremely competitive offers. They often are not of the mindset that they need to go back and forth with negotiations, because in many cases they already have offers that meet the majority of their requirements.

Flexibility on candidate parameters is particularly important for healthcare facilities seeking OB-GYNs. Though female OB-GYNs often are the first preference of patients, each candidate, male or female, should be considered based on their individual merits. A male candidate with a positive, empathetic bedside manner and strong communications skills may be more successful than a female candidate who lacks these skills. The same can be said for older candidates or those just completing residency.

Begin with the skills and personal qualities you wish to see in a candidate rather than preconceptions about appearance, age, national origin, or gender.

About AMN Healthcare Physician Solutions

AMN Healthcare Physician Solutions was originally established in 1987 as Merritt Hawkins. AMN Healthcare provides permanent physician, locum tenens, advanced practitioner, plus, leadership, language services, nursing, and allied staffing and search services to hospitals, medical groups, community health centers, telehealth providers and many other types of entities nationwide.

As a thought leader in our industry, AMN Healthcare produces a series of surveys, white papers, books, and webinar presentations internally and produces research and thought leadership for third parties.