CorEvitas, LLC, Waltham, MA.
Holley Clinic, Quesnel, BC, Canada.
Fam Med. 2023 Oct;55(9):582-590. doi: 10.22454/FamMed.2023.966628. Epub 2023 Jul 24.
The number of family physicians who include obstetric care in their scope of practice is declining, resulting in lower access for patients to obstetric care, especially in rural and underserved communities. In our study, we aimed to understand the experiences of mid- to late-career family physicians and capture suggestions regarding how to maintain obstetric deliveries as part of practice throughout their careers.
We administered a 30-item online survey to mid- to late-career family physicians regarding their obstetrical care practice and their suggestions for family physicians to continue attending deliveries throughout the course of their career. We developed descriptive statistics of individual and practice characteristics and thematically analyzed open-text comments offering suggestions for continuing to provide obstetric care.
About 1,500 family physicians agreed to participate in the online survey, 992 of whom responded to an open-text question asking for suggestions for family physicians hoping to continue providing obstetric care throughout their careers (56% response rate). The primary themes included suggestions regarding interprofessional relationships, call coverage/backup, training and education, practice characteristics, practice setting, work-life balance, job seeking, policy, and compensation.
The findings revealed individual- and structural-level considerations to improve longevity in obstetric scope of practice. Support from multiple levels is necessary to ensure that competent family physicians continue attending deliveries throughout their careers. Practices and hospital systems can have a sizeable impact by directly helping family physicians provide obstetric primary care within their scope of practice, while national organizations can influence health care system-level changes.
提供产科护理的家庭医生人数正在减少，导致患者获得产科护理的机会减少，尤其是在农村和服务不足的社区。在我们的研究中，我们旨在了解中年至晚期职业家庭医生的经验，并了解他们对如何维持产科分娩作为其整个职业生涯实践一部分的建议。
我们向中年至晚期职业家庭医生发放了一份关于其产科护理实践的 30 项在线调查，并征求他们对家庭医生在整个职业生涯中继续进行分娩的建议。我们对个人和实践特征进行了描述性统计分析，并对提供继续提供产科护理建议的开放文本评论进行了主题分析。
约有 1500 名家庭医生同意参加在线调查，其中 992 名家庭医生对一个开放文本问题做出了回应，该问题要求家庭医生就希望在整个职业生涯中继续提供产科护理提出建议（响应率为 56%）。主要主题包括关于专业间关系、值班/后备、培训和教育、实践特征、实践环境、工作与生活平衡、求职、政策和补偿的建议。
调查结果揭示了个体和结构层面的考虑因素，以提高产科实践范围的持久性。需要多层面的支持，以确保有能力的家庭医生在整个职业生涯中继续进行分娩。实践和医院系统可以通过直接帮助家庭医生在其实践范围内提供产科初级保健来产生相当大的影响，而国家组织可以影响医疗保健系统层面的变化。
