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In for the long haul. Which family physicians plan to continue delivering babies?
Michael C Klein1, Ann Kelly, Andrea Spence
1Division of Maternity and Newborn Care, Department of Family Practice, University of British Columbia, Vancouver. mklein@interchange.ubc.ca
Objective:
To compare characteristics of family physicians planning to discontinue or stay in intrapartum care.
Design:
Self-administered questionnaire.
Setting:
Department of Family Practice at Children's and Women's Health Centre of British Columbia.
Participants:
Ninety-five family physicians who attended at least one birth at the Health Centre between April 1997 and August 1998.
Main Outcome Measures:
Intention to leave or stay in family practice maternity care, physician characteristics and beliefs.
Results:
Forty-five percent (43/95) of family physicians planned to leave maternity care within the next 5 years. Physicians planning to leave had more negative attitudes about the alternative birthing centre, doulas, and practising in free-standing settings without on-site obstetricians; were more likely to report missing personal events because they had put their maternity patients first; were less likely to make housecalls during women's labour; and were more likely to be paid through fee-for-service.
Conclusion:
Being paid by fee-for-service, having negative attitudes toward non-traditional maternity care, and conflict between maternity care and personal life were associated with intention to leave intrapartum care.