Factors influencing the evolving practice of obstetricians in eastern Wisconsin: a survey

The purpose of this survey was to ascertain what prompts clinicians in eastern Wisconsin to change their obstetric practice. A survey was mailed to all clinicians doing obstetrics for a nonprofit organization that performs over 11,000 deliveries in 10 hospitals. Of the 185 surveys mailed, 90 (49%) practicing obstetricians returned it. To change their practice, 31% of respondents said they need the American College of Obstetricians and Gynecologists (ACOG) to recommend it; 24% required multiple randomized clinical trials (RCTs) from different centers; 11% thought one RCT was sufficient. Whereas 93% of the respondents will change their practice within 2 years of a new ACOG recommendation, only 67% will do so after an RCT (odds ratio 6.42; 95% confidence intervals 2.46, 16.75). We concluded that ACOG recommendations are more likely to change the practice of clinicians doing obstetrics in eastern Wisconsin than RCTs.