The Future of Women's Health

How Telehealth Solutions Can Counter America's Growing OB-GYN Shortage

American women face a growing crisis: a shortage of doctors specializing in women’s health. Despite the rapid growth of

the US female population, from 89.5 million women over the age of 18 in 1992 to 123.1 million in 2016 (1.8% growth compounded annually), the number of Accreditation Council for Graduate Medical Education (ACGME) obstetrician-gynecologist (OB-BYN) residency programs has decreased (from 257 in 1992 to 246 in 2016), and the number of first-year OBGYN residency positions has only increased minimally from 1,110 in 1992 to 1,287 in 2016 (0.8% increase compounded annually). In addition, the density of OB-GYNs has decreased across the board in both city and rural areas.

This number continues to decline despite the fact that the highest proportion of doctors come from underrepresented minorities (African Americans at 11.1% and Hispanics at 6.6%) who have a higher likelihood of working in under-served communities. Shockingly, almost half of the 3,143 US counties lack a single practicing OB-GYN, leaving more than 10 million women (8.2% of all women) out of reach of adequate or any OB-GYN care. Commonly designated Health Professional Shortage Areas, such as in Central and Mountain West regions, have become especially vulnerable.

Research consistently shows that follow-up rates drop by as much as 40% when patients, referred to a specialist, must travel 29 miles or more for an examination. With these gaps expected to grow, more women will not have access to the important women’s health services they require including prenatal and obstetric care, and annual well-woman examinations that screen for breast, cervical and ovarian cancers, STIs, sexual dysfunction, painful menses, fibroids, endometriosis, and other related disorders.

With up to a quarter of all women seeking some type of OB-GYN care, a reduction in the availability of OB-GYNs will force a greater reliance on other clinicians such as family doctors, nurse practitioners, physician assistants, midwives and other health workers. This has an even bigger impact in under-served communities that face both financial and location-based challenges to accessing appropriate care.

“We need to incentivize doctors to move to under-served areas but also ensure that mid-level clinicians, not just doctors, are trained to identify problems, then refer onto specialist care only when needed,” agrees Jose Carugno, MD, and Director of the Minimally Invasive Gynecology Surgery and Robotic Unit at the University of Miami’s Obstetrics and Gynecology department, “It is also important to find ways of reducing the cost of care to enable more women to access

women’s health services.”

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