More than one-half (52%) of ObGyns spend 30 to 45 hours per week seeing patients. Fewer (38%) spend more than 45 hours per week, and 9% spend less than 30 hours per week with patients. This decline may be due to the increasing proportion of women and older physicians who tend to work shorter hours and fewer weeks.1
In the general physician population, 24% of women and 13% of men work part time, whereas 16% of both men and women ObGyns work part time. ObGyns aged 65 years or older constitute 35% of part-timers; 9% of those aged 35 to 49 years, and 11% of those aged 50 to 64 years, work part time. Only 2% of those younger than 35 work part time.1
If given a second chance, would you rather choose orthopedic surgery as your specialty, or even choose medicine as a career again? OBG Management recently asked readers to weigh in, through its Quick Poll posted at www.obgmanagement.com, on whether or not they would choose ObGyn all over again. Ninety-one readers answered “yes” and 70 answered “no,” for a total of 161 respondents.
When this same question was posed to OBG Management’s Virtual Board of Editors, the perspectives were as split as the Quick Poll results:
- “No, no, no,” I would not choose ObGyn all over again.
- “Yes, I still love what I do.”
- “Yes, it is still the most unique specialty in medicine because it involves both surgery and primary care.”
- “Yes, for all the reasons I first loved the specialty: every week's schedule, and every day is different. There is a mix of office care, surgery, and call.”
- “No! There is constant concern of litigation for complications, poor reimbursement, and compromised lifestyle.”
“There are much easier ways to make a living,” said one respondent, and another replied, “Work is very tough right now and the payment is too low.”
“The specialty has changed,” said Mary Vanko, MD, who practices in the suburbs of “blue collar Indiana.” “The public has very little idea of the breadth of our knowledge. The ObGyn generalist has the ability to serve as a woman's doctor throughout her lifetime, not just perform the deliveries and surgeries. All of a sudden we are excluded from primary care status and people have to fight to see us. The newbies will never experience what it used to be as an ObGyn, the woman's primary. Now we are the doctors to see when someone wants an IUD or is bleeding or pregnant. Big difference.”
Wesley Hambright, MD, practices in a small community hospital, but feels that “a larger hospital with more specialties may offer more flexibility and support in dealing with external pressures.” Tameka O’Neal, MD, is currently hospital employed but feels “as though I have little say in my practice.” Shaukat Ashai, MD, who is retired after 35 years in practice, says he would have would have preferred an academic setting on a full-time basis, citing long hours and poor compensation.
Robert del Rosario, MD, is in a large single-specialty suburban practice, and would choose this practice setting again, although he would not choose a career as an ObGyn again. “The work demands have taken away too much from family,” he says. In addition, “as a male ObGyn, I am regularly faced with patients who choose their doctors based on gender rather than on skill. Our colleagues are no better. Early in my career and until the present, I hear people say, ‘Oh, I can't hire "X" because we're looking to hire a female.’”
Joe Walsh, MD, of Philadelphia, Pennsylvania, expresses similar discontent as a male ObGyn practicing in today’s female-populated specialty. In a letter to the editor in response to Editor in Chief Robert L. Barbieri, MD’s Editorial in the May 2015 issue, “Why is obstetrics and gynecology a popular choice for medical students?” Dr. Walsh states, “The unaddressed question is why it is unpopular for half of medical students? Ninety-three percent of resident graduates in the field are women, while women account for half of medical student graduates. Men rarely go into the field today. Perhaps job advertisements touting physician opportunities in ‘all female groups’ discourage men. Perhaps hospitals' ‘Women's Health Centers’ with such slogans as ‘Women taking care of women’ discourage men. Perhaps receptionists' asking patients whether they prefer a male or female physician discourages male ObGyns.”
Many VBE members express some frustrations—with their practice setting, compensation, and longer work hours—but say that the patient relationships are the most rewarding aspect of their jobs. After 29 years in practice, Patrick Pevoto, MD, says the most rewarding aspect of his job is “being part of the legacy in people’s lives.”
Others say what keeps them engaged is:
- Enjoying “good outcomes.”
- “The patient contact. It's fun having someone come up to me in the grocery store and introduce me to a teenager that I delivered 15 years ago.”
- “Surgery.”
- “Helping patients and teaching fellows.”
- “Knowing that I am making a difference in people’s lives.”