Goldstein Jessica Taylor, Hartman Scott G, Meunier Matthew R, Panchal Bethany, Pecci Christine Chang, Zink Nancy M, Shields Sara G
UCSF Natividad Family Medicine Residency.
University of Rochester Medical Center, Rochester, NY.
Fam Med. 2018 Oct;50(9):662-671. doi: 10.22454/FamMed.2018.325322.
Maternity care access in the United States is in crisis. The American Congress of Obstetrics and Gynecology projects that by 2030 there will be a nationwide shortage of 9,000 obstetrician-gynecologists (OB/GYNs). Midwives and OB/GYNs have been called upon to address this crisis, yet in underserved areas, family physicians are often providing a majority of this care. Family medicine maternity care, a natural fit for the discipline, has been on sharp decline in recent years for many reasons including difficulties cultivating interdisciplinary relationships, navigating privileging, developing and maintaining adequate volume/competency, and preventing burnout. In 2016 and 2017, workshops were held among family medicine educators with resultant recommendations for essential strategies to support family physician maternity care providers. This article summarizes these strategies, provides guidance, and highlights the role family physicians have in addressing maternity care access for the underserved as well as presenting innovative ideas to train and retain rural family physician maternity care providers.
美国的孕产妇保健服务正处于危机之中。美国妇产科学会预计，到2030年，全国将短缺9000名妇产科医生。助产士和妇产科医生被要求应对这一危机，但在服务不足的地区，大部分此类护理工作通常由家庭医生提供。家庭医学孕产妇保健服务，本应是该学科的自然契合点，但近年来却急剧下降，原因包括难以建立跨学科关系、应对特权授予、发展并维持足够的工作量/能力，以及预防职业倦怠。2016年和2017年，在家庭医学教育工作者之间举办了研讨会，随后提出了支持家庭医生孕产妇保健服务提供者的基本策略建议。本文总结了这些策略，提供了指导，并强调了家庭医生在为服务不足人群提供孕产妇保健服务方面所起的作用，同时还介绍了培训和留住农村家庭医生孕产妇保健服务提供者的创新理念。
