Greer T, Baldwin L M, Wu R, Hart G, Rosenblatt R
Department of Family Medicine, University of Washington School of Medicine, Seattle 98195.
J Am Board Fam Pract. 1992 Jul-Aug;5(4):407-12.
Decreased numbers of obstetric providers during the last decade have limited access to obstetrics care, especially for some groups of women. Increasing or stabilizing the number of providers could increase access.
A questionnaire was mailed in 1989 to 1965 Washington State family physicians and obstetricians to determine their attitudes toward the practice of obstetrics. Sixty-six percent of physicians responded to the survey.
Of those who had quit obstetrics in the previous 3 years, 42 percent of responding family physicians and 19 percent of responding obstetricians would consider resuming. Those family physicians willing to consider resuming their obstetric practices were more likely to have been in practice fewer years, employed by a health maintenance organization (HMO), or located in a rural area. A majority of all respondents cited excessive malpractice premiums and fear of malpractice suit as reasons for stopping obstetric practice. Family physicians willing to consider resuming obstetrics were more concerned about the overall number of obstetric providers in their area. Rural family physicians willing to consider resuming obstetrics listed poor backup or shared call more often as a reason they had quit.
Attention targeted to the concerns of family physicians who have been in practice for a short time, who work for HMOs, or who are in rural practice might help induce some physicians to resume obstetrics.
在过去十年中,产科医疗服务提供者数量的减少限制了人们获得产科护理的机会,尤其是对某些女性群体而言。增加或稳定医疗服务提供者的数量可能会增加获得护理的机会。
1989年向1965名华盛顿州的家庭医生和产科医生邮寄了一份调查问卷,以确定他们对产科医疗实践的态度。66%的医生回复了该调查。
在过去3年中停止从事产科工作的人中,42%回复调查的家庭医生和19%回复调查的产科医生会考虑恢复产科工作。那些愿意考虑恢复产科医疗实践的家庭医生更有可能从业年限较短、受雇于健康维护组织(HMO)或位于农村地区。所有受访者中的大多数人将过高的医疗事故保险费和对医疗事故诉讼的恐惧作为停止产科工作的原因。愿意考虑恢复产科工作的家庭医生更关注其所在地区产科医疗服务提供者的总体数量。愿意考虑恢复产科工作的农村家庭医生更常将后备支持不足或共享值班作为他们停止从事产科工作的原因。
关注那些从业时间短、为健康维护组织工作或在农村地区执业的家庭医生所关心的问题,可能有助于促使一些医生恢复产科工作。