The Family Doctor in Obstetrics: Who's Looking after the Shop?

This article constitutes a report on a survey of 1338 family physicians/general practitioners in Ontario. The survey, which achieved a response rate of 74%, investigated respondents' patterns of obstetrical practice and attitudes towards that practice. The detailed statistics collected show a decline in FP/GP involvement in obstetrical care. Physicians who had never practised obstetrics cited inadequate training and lack of interest as their chief reasons. Physicians who had given up obstetrical practice cited most frequently its interference with personal and family life, interruption of office schedule, rising CMPA fees, and low financial incentives as reasons for their decision. In the youngest group of respondents, no significant differences were found between males' and females' rates of choice to practise or not to practise obstetrics. Respondents who had never practised obstetrics were likely to live in larger communities, and those practising obstetrics to live in smaller communities. Various changes in patterns of practice were identified by some respondents subsequent to their giving up obstetrics. A large majority of this group expressed satisfaction with those changes. Over half the respondents stated that they would accept well-trained midwives practising under supervision in a hospital setting. A strong majority of respondents favoured the concept of family physicians with a special interest in obstetrics taking over, either alone or in association with obstetricians and/or midwives, the obstetrical cases declined by their colleagues.