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10 million women have no doctors to treat them: The OB-GYN shortage in America

Jul 23, 2018 | Blog

Today in America, there are many women that do not have access to an OB-GYNs to provide care for them. With the shortage of OB-GYN coverage quickly becoming a crisis, some healthcare systems look to new technologies in order to overcome the gap.

OB-GYNs provide essential treatment for  maintaining women’s health. Many diseases such as cervical cancer are entirely preventable if caught in time. The screening provided by women’s health practitioners saves countless lives that otherwise would fall victim  preventable diseases. OB-GYNs are the bastion of women’s health professionals, providing the knowledge and care needed to help women live healthy lives. Even areas with Women’s Health Nurse Practitioners (WHNP) present still require an OB-GYN to provide advanced treatment.

Millions Without Any OB-GYN Coverage

Yet shockingly almost half of the country’s 3,143 counties lack any practicing OB-GYN. This leaves more than 10 million women without any coverage. That means 8.2% of all US women have little or no access to an OB-GYN. Most of those without coverage live in rural or remote areas such as the Central and Mountain West regions.

“We need to incentivize doctors to move to underserved areas,” argues Jose Carugno, MD, and Director of the Minimally Invasive Gynecology Surgery and Robotic Unit at the University of Miami’s Obstetrics and Gynecology department. “If women don’t get consistent access to care, any potential disease that may be present will progress. Then when she shows up at doctor, the disease will be at an advanced stage and more difficult and costly to treat.”

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The numbers of women needing care continues to grow more rapidly than the number of new OB-GYNs receiving training. The number of women in the US has grown significantly from 89.5 million in 1992 to 123.1 million today, a compound annual growth of 1.8%. Meanwhile, the number of new OB-GYNs trained in the specialty cannot keep up with the growth. In 1992, there were 1,110 first year OB-GYN residency spots available. The number only rose to 1,287 by 2016, representing a mere 0.8% compound annual increase.

95% of OB-GYNs belong to the American Council of Obstetricians and Gynecologists, which currently lists 35,586 ACOG members. This would suggest that, at most, only 40,000 practicing OB-GYNs serve a population of 123.1 million women total.

Many Women Don’t Attend OB-GYN Checkups

Even these figures may not accurately represent the present realities. Many women do not attend OB-GYN practices unless  either pregnant or experiencing a medical issue. Many women do not yet understand the full benefits of preventative screening or lack the funds to cover such screening.

“In the US, there is a culture that is less about preventative care and more focused on problem-

based care,” explains Deborah Nucatola, MD, Medical Director, Hawaii and Planned Parenthood of the Great Northwest and the Hawaiian Islands, and Director of Family Planning at the Eden Surgical Center. “A large number of patients that need care don’t actually go and get that care. They just wait until a problem or symptom develops, and that’s when they enter the system.”

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Only a quarter of all women will seek some form of OB-GYN care on an annual basis. The lack of OB-GYN availability may further prevent women from obtaining the necessary screening and well-woman examinations needed to find disease in the early stages.

Retirement Adds to the OB-GYN Shortage

Unless women’s health and OB-GYN practices change significantly, the need for more OB-GYN doctors will become even greater. Doximity reports that most most OB-GYNs begin to retire at 59 years old. With 37% of practicing OB-GYNs aged over 55, the shortage will increase even more as these doctors begin to retire with not enough younger doctors to replace them in the profession. The number of OB-GYNs under 40 remains as low as 14%. This will create an additional strain on the already lacking OB-GYN services available.

The Telehealth Solution

A radical solution has been proposed to help correct the shortage of OB-GYNs – not to train more doctors, but rather to extend their influence through technological means. Telehealth has quickly become a buzzword in the healthcare world. It allows other providers such as nurses or family doctors to consult with expert doctors remotely. For example, a nurse practitioner screening a patient for cervical cancer in the Appalachian mountains could instantly send images to an expert OB-GYN in Texas for consultation. While the patient is still present, an answer could be received and further treatment recommended.

“Telehealth allows us to reach patients wherever they are. Patients can be seen at a local clinic with expert consultation provided remotely,”  says Nucatola, who has incorporated telehealth into her practice. “Importantly, patients receive similar support and counseling opportunities to in-person consultations.”

In the area of cervical cancer screening, telehealth has already become a practical reality with the EVA System, a mobile colposcope that uses a secure HIPAA compliant online system to send images of the cervix in real-time for immediate consultation. Currently, 50 healthcare systems in 27 countries use the system around the world helping to reduce the strain on the medical system caused by the shortage of OB-GYNs. Thanks to the EVA system, thousands of women can receive vital screenings they might otherwise have had to do without.

Unless the number of OB-GYN residency programs suddenly increases, the current shortage of OB-GYNs in the USA will not be solved by simply hiring more doctors. The time has come to embrace new methods of solving the shortage such as the telehealth option in order to best serve the women of America.


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