Are Obstetrician-Gynecologists Satisfied with Their Maternal–Fetal Medicine Consultants? A Survey

Abstract

Objective To survey generalist obstetrician-gynecologists about their satisfaction with and patterns of referral to maternal–fetal medicine (MFM) specialists.

Study Design A survey was sent three times to 1030 randomly selected American Congress of Obstetricians and Gynecologists members across the country, and results were tabulated.

Results A total of 516 surveys (50%) were returned; 68% of respondents were satisfied (S) with available MFM services and 31% were not satisfied (Not S). S and Not S respondents were similar with respect to age, gender, years in practice, type of practice, hours worked per week, proximity to MFM specialists, number of deliveries per year, and level of nursery in their hospital. Reasons for dissatisfaction included: MFM specialist not readily available (49%), during the day (26%), at night (35%), or on weekends (36%); MFM specialist unwilling to take care of hospitalized patients (26%); or MFM specialist does only ultrasound, chorionic villus sampling, and amniocentesis (32%). Although some generalists do not consult MFM specialists frequently, the majority of both S and Not S respondents would request an MFM consult or comanagement for 26 of 38 specific maternal, fetal, and obstetric diagnoses/complications.

Conclusion The majority of obstetrician-gynecologists are satisfied with their MFM support. The dissatisfaction expressed by 31% of generalists might be ameliorated if individual MFM specialists increased their availability and/or broadened their scope of practice.

Keywords

generalist's opinion of MFM services

• References

• 1 Frigoletto FD, Greene MF. Is there a sea change ahead for obstetrics and gynecology?. Obstet Gynecol 2002; 100: 1342-1343
• 2 Berg CJ, Callaghan WM, Syverson C, Henderson Z. Pregnancy-related mortality in the United States, 1998 to 2005. Obstet Gynecol 2010; 116: 1302-1309
• 3 Danel I, Berg C, Johnson CH, Atrash H. Magnitude of maternal morbidity during labor and delivery: United States, 1993–1997. Am J Public Health 2003; 93: 631-634
• 4 Lorenz RP, Sokol RJ, Chik L. Survey of maternal-fetal medicine subspecialists: professional activities, job setting, and satisfaction. Obstet Gynecol 1989; 74: 962-966
• 5 Lorenz RP, Sokol RJ, Chik L. Survey of maternal-fetal medicine subspecialists: professional activities, job setting, satisfaction, and trends over time. J Matern Fetal Med 1998; 7: 273-276
• 6 Wing DA, Quilligan EJ. Fellowship training: the ever-changing subspecialty of maternal-fetal medicine. Obstet Gynecol 2008; 112: 1288-1293
• 7 D'Alton ME, Poole S, Rinehart RD. Society of Perinatal Obstetricians: The First Two Decades. Washington, DC: SPO; 1997
• 8 Merrill JA. (Sub)specialization in obstetrics and gynecology: results of a survey by the American Board of Obstetrics and Gynecology. Am J Obstet Gynecol 1987; 156: 550-557
• 9 D'Alton ME. Where is the “M” in maternal-fetal medicine?. Obstet Gynecol 2010; 116: 1401-1404
• 10 Vintzileos AM, Ananth CV, Smulian JC, Scorza WE, Knuppel RA. Defining the relationship between obstetricians and maternal-fetal medicine specialists. Am J Obstet Gynecol 2001; 185: 925-930
• 11 Lao TT, Leung W-C. Defining the relationship between obstetricians and maternal-fetal medicine specialists (letter to the editor). Am J Obstet Gynecol 2002; 187: 257 ; author reply 257–258