anticipated shortages of physicians comparisons between...
TRANSCRIPT
![Page 1: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/1.jpg)
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
![Page 2: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/2.jpg)
![Page 3: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/3.jpg)
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
![Page 4: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/4.jpg)
American College of Surgeons
General surgery Obstetrics and gynecology Orthopedics Otolaryngology Opthalmology Neurosurgery Urology Plastic surgery
![Page 5: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/5.jpg)
Data Sets AAMC Association of American Medical Colleges
ACOG American College of Obstetricians and Gynecologists
AHA American Hospital Association
Merritt Hawkins Search Firm
NRMP National Resident Matching Program
U.S. Census Bureau
![Page 6: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/6.jpg)
Percent U.S. Medical Graduates and Specialty Salary
AAMC
![Page 7: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/7.jpg)
Residency Programs, 2011
Programs Positions
Family medicine 453 2,708
General surgery 296 1,179
Ob-gyn 237 1,205
NRMP
![Page 8: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/8.jpg)
Ob-Gyn Residents and Programs
NRMP
![Page 9: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/9.jpg)
Female Residents in Accredited Programs
Average 46.0%
Family medicine 55.6%
Ob-gyn 79.7%
General surgery 35.0%
NRMP
![Page 10: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/10.jpg)
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
![Page 11: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/11.jpg)
Hispanic Residents in Accredited Programs
Average 8.0%
Family medicine 9.7%
Ob-gyn 9.0%
General surgery 8.3%
NRMP
![Page 12: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/12.jpg)
Abdominal hysterectomy Vaginal hysterectomy Laparoscopic hysterectomy Treatment of incontinence/pelvic floor repair Laparoscopy Operative hysterectomy Abortion Treatment on invasive cancer
Gyn Procedures Performed by Residents
ACOG
![Page 13: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/13.jpg)
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
![Page 14: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/14.jpg)
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
![Page 15: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/15.jpg)
Patients in the General Population Per Active Physician
Internal medicine 2,875
Family medicine 2,919
Pediatrics 5,579
Ob-Gyn 7,600
Psychiatry 7,661
![Page 16: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/16.jpg)
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
![Page 17: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/17.jpg)
per 10,000 women
ACOG
![Page 18: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/18.jpg)
per 10,000 women
Densities of Ob-Gyns
per 10,000 women
ACOG
![Page 19: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/19.jpg)
Active Female Physicians by Medical Specialty, 2007
Average 28.3%
Family medicine 31.3%
Ob-gyn 43.2%
General surgery 13.6%
AAMC
![Page 20: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/20.jpg)
Average Age at Which Fellows Stop Practicing Obstetrics
Year All Fellows (Years)
Males (Years)
Females (Years)
1985 49.4 No data No data 1987 49.3 No data No data 1990 49.8 No data No data 1992 48.9 50.2 39.5 1996 46.6 48.4 39.2 1999 48.2 51.2 40.8 2003 48.0 51.0 42.0 2006 48.0 51.7 43.1 2009 48.0 51.9 43.8
ACOG
![Page 21: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/21.jpg)
Hospitals with Maternity Services
AHA
![Page 22: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/22.jpg)
Hospitals with Maternity Services 60-Minute Drive
AHA USCB
![Page 23: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/23.jpg)
Hospitals with Maternity Services 30-Minute Drive
AHA USCB
![Page 24: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/24.jpg)
Mean Ages of Male/Female Fellows at ACOG
ACOG
![Page 25: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/25.jpg)
Age Intervals of the Fellows of ACOG
ACOG
![Page 26: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/26.jpg)
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
![Page 27: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/27.jpg)
Change in Number of Active Physicians 1996-2006
General surgery -1.0%
Ob-gyn 10.2%
Family medicine 33.0%
AAMC
![Page 28: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/28.jpg)
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 2 Obstetrics and gynecology 11 20 54 13 2
MH
![Page 29: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/29.jpg)
Topics Assessed at a Typical Women’s Annual Visit
Cervical cytology Breast examination Pelvic examination Alcohol, tobacco, or drug use Sexuality concerns Fitness and nutrition Psychologic well-being Cardiovascular risk factors Immunizations
ACOG
![Page 30: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/30.jpg)
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
![Page 31: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/31.jpg)
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 medicine 10. Psychiatry
MH
![Page 32: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/32.jpg)
ACOG
![Page 33: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/33.jpg)
Advanced Ob-Gyn Training
Maternal-Child health fellowship
Women’s Health training in internal medicine
Re-entry of Ob-Gyns in the workforce
![Page 34: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/34.jpg)
Nonphysician Practitioners
Types of Nonphysician Practitioners
Training Programs in the United States (N)
Estimated Nonphysician
Practitioners (N)
Certified nurse-midwives 38 11,546
Nurse practitioners 350 135,000
Physician assistants 140 85,345
ACOG
![Page 35: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/35.jpg)
![Page 36: Anticipated Shortages of Physicians Comparisons between ...unmfm.pbworks.com/w/file/fetch/47803346/Anticipated...U.S. Census Bureau Percent U.S. Medical Graduates and Specialty Salary](https://reader034.vdocuments.us/reader034/viewer/2022051900/5fef1c0790e0d849683b2e40/html5/thumbnails/36.jpg)
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