Retaining the perinatal care workforce: Lessons learned from experienced physicians who no longer attend deliveries.

Objective: To inform policy supporting the retention of family physicians (FPs) in the perinatal care workforce by identifying physician characteristics that are associated with retention.

Data Sources And Study Setting: We surveyed FPs who had been in practice for at least 11 years and reported attending deliveries as part of their practice.

Study Design: We compared the characteristics of FPs who continue to provide perinatal care to those who have ceased and explored their reasons for no longer attending deliveries.

Data Collection/extraction Methods: We estimated a probit regression with the dependent variable: whether the physician currently delivers babies. Open-ended survey responses were analyzed and close-coded using a conceptual content analysis approach.

Principle Findings: Of the FPs who received a survey, 1505 (37%) responded. Those who continue attending deliveries were more likely to receive a stipend or be paid per hour/shift in addition to their salary versus those paid a salary (percentage point difference = 13), and less likely to work part-time versus full-time (percentage point difference = -20). Those who ceased attending deliveries cite lifestyle (n = 208), call structure (n = 113), and delivery volume (n = 89) among the reasons for doing so.

Conclusions: Evidence-based policies aimed at preventing attrition from the perinatal care workforce, which might include targeting compensation models and work-life balance.