Technology ups and downs
Another fairly new pressure on ob.gyns. is the integration of the electronic health record and the federal reporting requirements that go along with it.
“Most practicing ob.gyns. are really fed up with the computerization of medicine and the tasking and the charting,” Dr. Montgomery said. “For every hour you spend seeing patients, you spend 1 or 2 hours doing computer chart work and paperwork. Most doctors don’t go into medicine so they can type; they go into medicine to take care of patients.”
The Internet age also poses challenges when it comes to patients conducting their own “research,” said Megan Evans, MD, an ob.gyn. at Tufts Medical Center, Boston.
Dr. Megan Evans
Protecting the security of patients’ medical records in the digital age is another worry, she said.
But for Dr. Evans, who completed her residency training in 2015, having dozens of digital tools at her disposal as she treats patients is definitely an upside to today’s practice environment.
“I can review a practice bulletin, look up the latest treatment regimens, and contact my colleagues with a quick question – all on my iPhone,” she said. “I also believe there is so much potential for electronic medical records and how they communicate with each other.”
Advancements in ultrasound, fetal monitoring, and other medical technologies have also allowed ob.gyns. to intervene earlier and save lives.
Dr. Brabson recalled the helplessness he and other physicians felt in the 1970s when it came to delivering extremely premature babies.
“We didn’t really feel like you could save a baby under 2 pounds,” he said. “When I was a medical student, if you had a baby under 2 pounds, very commonly what they would do is lay the baby up on the table and watch and see how vigorous it was going to be, and if it really did breathe and carry on for awhile, then you might take it to the nursery. The equipment that we have to save babies with today, compared to 40 years ago, that’s a dramatic change.”
A changing focus for the future
If current trends continue, Dr. Brabson’s early experience of being a generalist ob.gyn. won’t be the norm. Instead, more ob.gyns. will choose to subspecialize. Whether this change is positive or negative for the specialty depends on who you ask.
“You could argue the pros and cons for both sides,” Dr. Zeligs said. “For me, it takes away from what drew me to the specialty – the breadth that ob.gyn. offers, both as a primary care specialty and as a surgical subspecialty.”
However, choosing one focus may offer some doctors a way to capture that elusive professional and personal balance, she added.
Despite the changing landscape of clinical duties and business operations, some parts of ob.gyn. practice have remained intact, according to Dr. Brabson. “The most rewarding and enjoyable part of the job is developing a relationship of mutual trust and respect,” he said. “As a result of developing such a relationship, both the patient and the doctor come away with positive feelings. This has not changed.”
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