Manpower in Obstetrics-Gynecology in a Period of Declining Birth Rate

This paper examines the reallocation of obstetrician time and the possible use of physician substitutes in relation to the changeover to a low birth rate and the need for family planning services in the United States. Published data from the American College of Obstetricians and Gynecologists, the American Medical Association, and other sources are used to develop a composite picture of ob-gyn workloads, and physician time expended and income earned in obstetrics and family planning are compared. Estimates of the unmet need for family planning services are developed. The steady decline in the annual births in the United States over the past decade along with the increase in the number of obstetrician-gynecologists is considered in the context of this need. Use of auxiliary health personnel to stimulate market demand for services of the specialists through lower prices is explored, and the minimum size of the geographical market area and other assumptions required for this effect to occur are specified. Schemes for parttime service of auxiliaries are discussed.