Monday, Dec. 10, 2018 | 2 a.m.
Las Vegas has the highest risk of suffering a shortage of doctors in obstetrics and gynecology, according to a 2018 workforce study by Doximity, the largest medical social network in the U.S. The study ranked Las Vegas No. 1 among the 50 largest metropolitan areas in the country for a second year.
The report examines high workloads, OB-GYNs nearing retirement and young doctors entering the field. Cities such as Los Angeles, Miami, Detroit and St. Louis are also facing a looming shortage, and in Las Vegas that could cause problems in other areas of women’s healthcare. “There are many incidences where … women in general seek a lot of their primary care from OB-GYN providers,” said Dr. Amit Phull, vice president of strategy and insights at Doximity. “It’s not too far of a logical jump to predict that there could be ramifications in primary care … as well as preventive care and the overall quality of women’s health services that are provided by a workforce that’s stretched quite thin.” When it comes to pregnancy, there are a few options to consider to help bridge the possible shortage gap.
Solutions that could be driven by the medical community
“The fact that there is such a disparity across the nation makes me think that …[a solution] could be something as straightforward as reorganizing the workforce that currently does exist,” Phull said. “The longer-term solution is just being more aware of these upcoming issues based on the trends we see in the data, so we can get ahead of the problem before they ultimately spill over and impact patient care.” He suggested the following options for the medical community:
Solution #1: Recruit OB-GYNS from cities that don’t have a shortage by working with other municipalities that don’t suffer from a shortage.
Solution #2: Make the OB-GYN field appealing to more medical students in Southern Nevada and encourage more students to enter the field.
Other healthcare options for women
Family Physician: Many family physicians can help a woman through pregnancy and after childbirth. In some rural areas, family physicians even deliver babies.
By the numbers
165: Average number of live births delivered by an OB-GYN in Las Vegas annually.
70: Average number of live births delivered by doctors in cities such as Boston.
Midwife: A provider who helps with maternal care, including pregnancy, birthing and postpartum. There are two kinds of midwives, a certified nurse-midwife and a direct-entry midwife.
A certified nurse midwife has at least a bachelor's degree, is a registered nurse (RN) and has also completed an accredited certified nurse midwife graduate-level program. A CMN can deliver newborns and perform gynecological checkups.
A direct-entry midwife entered the industry through an apprenticeship under a midwife, self-study or at a midwifery school and college.
Doula: An individual trained in childbirth who provides emotional, physical and educational support to a mother during or after pregnancy. There are two forms of doulas—a birth doula and a postpartum doula.
A birth doula helps the mother understand the entire span of her pregnancy, develop a birth plan and act as an advocate in the hospital for the mother’s desires.
A postpartum doula helps a new mother adjust to having a baby in the household while helping the mother understand infant feeding, baby bonding and basic newborn care.
Why is Las Vegas at risk of a shortage?
Retirement: Areas with older OB-GYN populations and high workloads are expected to be at greatest risk for a shortage, according to the report. Nationally, the average age of OB-GYNS is 51—36 percent of practicing OB-GYNS are 55 or older, and 16 percent are 40 or younger. The majority begin to retire at 59, according to research by the American Congress of Obstetricians and Gynecologists. There will not be enough younger OB-GYNS to fill their positions, according to the report. Las Vegas ranks No. 1, with the lowest percentage of OB-GYNS younger than 40. Thirty nine percent are older than 55, and the average age is 51.98 years.
High Workload: Las Vegas ranked third for largest workloads.
Doulas for educational and emotional support?
Alicia Mattera, owner and founder of Doulas of Las Vegas, said that there’s a lot of misinformation on the role doulas.
“Doulas don’t do anything medical and they should not being doing anything medical—it’s out of our scope of practice,” Mattera said. “They [the public] get us confused with midwives, who actually deliver the babies. Doulas are there for education and support.”
Mattera said doulas can be for everyone, from first-time moms to women who have had traumatic childbirths previously.
“The OB-GYNs are super-slammed; they don’t have time to sit down and answer a million questions, and so they [the mothers] kind of get pushed aside,” Mattera said. “That’s where we come in to fill in that gap. We’re there to answer all the questions and give them that support so they know what’s going to happen to them when they walk into the hospital.”