JAMA. 1987 Dec 25;258(24):3547-53.
The American Medical Association Council on Long Range Planning and Development has identified trends in the environment of medicine that are likely to affect the future of obstetrics and gynecology practice. The professional liability crisis is among the most potent factors affecting the types and numbers of services that obstetricians and gynecologists will provide in the future. The setting for obstetrics and gynecology practice is likely to be affected by advances in technology and trends in delivery and reimbursement systems. Two factors with potential to affect the organization of practice are the high numbers of women entering the specialty and increasing practice expenses, largely associated with liability costs. Other factors affecting future patterns of delivery include the anticipated aging of the female population and the changing social and economic roles of women. In particular, the feminist movement has focused more attention on women's health care and is expected to have a continuing impact on the delivery of obstetric and gynecologic care. The Council concludes that the most salient issues for the specialty in the future will be the following: (1) the direction of the professional liability crisis, (2) medical practice competition, (3) the feminization of poverty, (4) ethical issues arising from technological and social imperatives, (5) the changing gender profile of the specialty, and (6) the impact of the feminist movement on women's health care.
美国医学协会长期规划与发展委员会已确定了医学环境中的一些趋势，这些趋势可能会影响妇产科实践的未来。职业责任危机是影响妇产科医生未来提供服务的类型和数量的最有力因素之一。妇产科实践的环境可能会受到技术进步以及分娩和报销系统趋势的影响。有两个因素可能会影响实践的组织形式，一是大量女性进入该专业领域，二是实践费用不断增加，这在很大程度上与责任成本有关。影响未来分娩模式的其他因素包括预计女性人口老龄化以及女性社会和经济角色的变化。特别是，女权运动更加关注女性医疗保健，预计将对妇产科护理的提供产生持续影响。委员会得出结论，该专业未来最突出的问题将是以下几点：（1）职业责任危机的走向，（2）医疗实践竞争，（3）贫困女性化，（4）技术和社会需求引发的伦理问题，（5）该专业不断变化的性别构成，以及（6）女权运动对女性医疗保健的影响。
