Barriers Faced by Family Medicine Graduates Interested in Performing Obstetric Deliveries

Barreto, Tyler; Eden, Aimee R.; Hansen, Elizabeth Rose; Peterson, Lars E.

doi:10.3122/jabfm.2018.03.170427

Cited by 16 publications

(20 citation statements)

References 2 publications

(1 reference statement)

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“…Research studies using data from the Graduate Survey have shown a large gap between practice and preparation 4 with further variation between academic-and community-based programs. 5 Other studies using the data have shown lower odds of burnout with broader scope of practice, 6 state-level variation in burnout, 7 associations between residency training and buprenorphine prescribing, 8 barriers to practicing obstetrics, 9 provision of contraceptive services and abortion care, 10,11 and participation in loan repayment programs. 12 Possible Uses and the Future With multiple years of data, residencies have the capability to identify persistent gaps in their curricula and make changes.…”

Section: Resultsmentioning

confidence: 98%

Using the Family Medicine National Graduate Survey to Improve Residency Education by Monitoring Training Outcomes

Peterson

2021

Fam Med

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Section: Resultsmentioning

confidence: 98%

Using the Family Medicine National Graduate Survey to Improve Residency Education by Monitoring Training Outcomes

Peterson

2021

Fam Med

Self Cite

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“…In addition, the proportion of family physicians practicing obstetrics is rapidly declining, despite findings that their outcomes are similar to those of obstetricians. Barreto et al 35 analyzed data from the 2016 Family Medicine National Graduate Survey (n ϭ 2018) to determine the extent and barriers to obstetric practice. Two barriers to providing obstetrics care were given by over half of the 865 new family physicians interested in delivering babies: 1) obstetrics was not available in their practice; and 2) lifestyle considerations.…”

Section: Agents Of Primary Care Implementationmentioning

confidence: 99%

Advancing the Science of Implementation in Primary Health Care

Bazemore¹,

Neale²,

Lupo³

et al. 2018

J Am Board Fam Med

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Implementation Science is commonly described as the study of methods and approaches that promote the uptake and use of evidence-based interventions into routine practice and policymaking. In this issue of JABFM, investigators share a wealth of new insights from the frontlines of Implementation Science in primary care: what it is, how we are doing it, and how it is advancing the evidence base of primary care. The breadth of implementation science in primary care is affirmed by the range of topics covered, from thought leader recommendations on future directions for the field, to reports on how best practices in policy and practice are shaping primary care implementation in the United States and Canada. There are also important updates on agents of primary care implementation themselves, such as practice facilitators, geriatric care teams, and family physicians interested in providing obstetric care. Other articles report on novel practice transformation efforts that advance health promotion and disease prevention, and innovative approaches to identifying and addressing social determinants of health in primary care practices and the communities they serve. The articles seem to generate as many new questions as they answer, and highlight the need for continued emphasis on advancing the science of implementation in primary health care. (J Am Board Fam Med 2018;31:307-311.)It is commonly estimated that evidence-based interventions require an average of 17 years to be incorporated into routine practice.1,2 Increasing payer and delivery system interest in narrowing that time gap has rapidly elevated the field of Implementation Science; the study of how evidence-based practice and policy can be effectively communicated, deployed, and brought to scale. Effective and efficient implementation is of particular importance in primary care, which is both the largest delivery platform and niche in the US health care ecology and an area largely neglected in the landscape of health care spending and biomedical research. 3,4 This theme issue of JABFM highlights lessons from, and efforts to advance implementation science in primary care.

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“…Contrary to previous research,10 15 of 2013 family medicine residency graduates who were interested in delivering babies but who were not doing so in practice 3 years later (n=856), few reported malpractice costs (24%) or privileging challenges (15%) as barriers to doing deliveries. However, 60% indicated that there was no opportunity to do deliveries in the practice they joined,16 raising questions about constraints placed on family physicians by employers or hospitals.…”

Section: Introductionmentioning

confidence: 99%

Experiences of new family physicians finding jobs with obstetrical care in the USA

2019

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ObjectiveThis study aimed to explore how new family medicine graduates who want to include obstetrics in their scope of practice identify and select jobs and to understand how employment influences scope of practice in family medicine, particularly the ability to provide maternity care and deliver babies.DesignMixed-methods study including a survey and qualitative interviews conducted in 2017.SettingWe electronically surveyed US family physicians and followed up with a purposeful subsample of these physicians to conduct in-depth, semistructured telephone interviews.Participants1016 US family medicine residency graduates 2014–2016 who indicated that they intended to deliver babies in practice completed a survey; 56 of these were interviewed.Main outcome measuresThe survey measured the reasons for not doing obstetrics as a family physician. To identify themes regarding finding family medicine jobs with obstetrics, we used a team-based, immersion–crystallisation approach to analyse the transcribed qualitative interviews.ResultsSurvey results (49% response rate) showed that not finding a job that included obstetrics was the primary reason newly graduated family physicians who intended to do obstetrics were not doing so. Qualitative interviews revealed that family physicians often find jobs with obstetrics through connections or recruitment efforts and make job decisions based on personal considerations such as included geographical preferences, family obligations and lifestyle. However, job-seeking and job-taking decisions are constrained by employment-related issues such as job structure, practice characteristics and lack of availability of family medicine jobs with obstetrics.ConclusionsWhile personal reasons drove job selection for most physicians, their choices were constrained by multiple factors beyond their control, particularly availability of family medicine jobs allowing obstetrics. The shift from physician as practice owner to physician as employee in the USA has implications for job-seeking behaviours of newly graduating medical residents as well as for access to healthcare services by patients; understanding how employment influences scope of practice in family medicine can provide insight into how to support family physicians to maintain the scope of practice they desire and are trained to provide, thus, ensuring that families have access to care.

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Barriers Faced by Family Medicine Graduates Interested in Performing Obstetric Deliveries

Cited by 16 publications

References 2 publications

Using the Family Medicine National Graduate Survey to Improve Residency Education by Monitoring Training Outcomes

Using the Family Medicine National Graduate Survey to Improve Residency Education by Monitoring Training Outcomes

Advancing the Science of Implementation in Primary Health Care

Experiences of new family physicians finding jobs with obstetrical care in the USA

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