Dobbs decision continues to affect US physician workforce
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Key takeaways:
- Patient-related and workforce-related factors influenced physicians’ practice decisions.
- Less than 10% of respondents reported that the abortion ban would not affect their choice of practice location.
The Dobbs v. Jackson Women’s Health Association decision continues to have a significant impact on the physician workforce, according to results of an online survey.
Critical efforts are needed to fully address the impact and sustain the physician workforce, researchers concluded.
Expansion of prior work
“This study expands upon our prior work on how the Dobbs decision effects training and practice location preferences by providing context for the etiology of our participants stated preferences,” Morgan S. Levy, MD, MPH, researcher at University of Kentucky, told Healio. “In our previous work, we found that 82.3% of medical students and physicians surveyed did not want to practice in a location with abortion restrictions.”
For the current analysis, investigators used data from an inductive thematic analysis of an additional posed question in the survey: “Please share your thoughts about the overturning of Roe v. Wade and how it will affect your decision about your (residency/job or fellowship) programs.”
One in four respondents of the overall survey (524 out of 2,063; 25.4%) also completed the free response item, which included 219 medical students, 129 residents and fellows, and 176 practicing physicians.
Common themes
Overall, 50.5% of survey respondents resided in states with abortion bans in place or expected, whereas 49.5% resided in states where abortion remained legal.
Researchers observed a higher likelihood for respondents of the free response question to reside in states with restrictive abortion bans (P < .001).
Results of the thematic analysis showed two broad thematic categories — patient-related and workforce-related factors — that influenced practice decision preferences.
Researchers further identified three specific common themes that affected practice preferences:
- patient access to care (47.5%);
- not choosing to practice or train in a state with abortion restrictions (47.5%); and
- personal belief that an abortion ban is a human rights/body autonomy violation (37.6%).
Of note, 7.8% of respondents reported that the abortion ban would not affect their choice of practice location, and 6.7% supported the decision.
“In the 2.5 years since the Dobbs decision, the physician workforce continues to be impacted,” Levy told Healio. “Our study shows that abortion restrictions will have a substantial impact on the physician workforce in patient care and practice location decisions.”
Researchers reported study limitations, including self-selection bias and that the study sample “focused on physicians and does not represent other health care workforce members likely impacted by abortion restrictions.”
A need to address physician concerns
“It is important that state policy makers and others who are considering abortion restrictions also consider how to address these concerns of physicians and medical students, to avoid worsening geographic maldistribution of physicians and worsening access to care from physicians for their citizens,” Levy said.
“This study enhances emerging literature about the impacts of abortion restrictions on the physician workforce, including physicians and medical students at all levels of training across all 50 states within both reproductive and nonreproductive health fields,” she continued. “It is critical to continue studying the enduring impacts of these decisions on the physician workforce.”
For more information:
Morgan S. Levy, MD, MPH can be reached at morganlevy@uky.edu.
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