Barriers to provision of obstetric services by family physicians in Louisiana.

The purpose of this paper is to identify family physicians' perceived barriers to providing obstetrical services in Louisiana. A questionnaire was sent to 585 active members of the Louisiana Academy of Family Physicians; 308 (52.5%) were returned. Only 10.4% currently provide obstetric services; 56.4% did so in the past. Physicians in urban practices were significantly more likely to offer obstetric services than those in rural practices (13.9% and 6.7%). The most common barriers related to the cost of malpractice insurance and protection from legal liability (32.8%), followed by lack of coverage (19.7%), not having enough time (12.8%), and lifestyle protection (11.3%). Respondents who provided obstetric care in the past were not significantly more likely to identify the cost of malpractice insurance as a barrier than those who had never provided OB services (35.9% and 29.1%). Barriers to providing obstetric services by Louisiana's family physicians result in only 1 in 10 doing so despite the emphasis given to obstetrics in their residency programs.