Projections of Australian obstetricians ceasing practice and the reasons.
OBJECTIVE
To assess the intentions of Australia's specialist obstetricians to cease practice and their reasons for abandoning this specialty.


METHODS
A structured questionnaire posted to Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), issued 11 July 2001 with a return date of 31 July 2001 (in practice, responses were accepted up to 31 August 2001).


METHODS
Australian specialists holding a Fellowship of the RANZCOG.


METHODS
Demographic data (eg, age, sex); type and location of practice; past, current and intended future obstetric practice; reasons for stopping practice; cost of indemnity premiums; experience of litigation and its influence on practice; and experience in giving medicolegal opinion.


RESULTS
The response rate was 74% (829/1116), with 826 responses fulfilling our selection criteria. The median number of years since admission as a Fellow was 17 (range, 1-47 years), and 19% (158/817) of respondents were women (9 people did not specify their sex). Of the 826 respondents, 596 (72%) were currently practising obstetrics, 548 (66%) intended to still be practising after one year, 365 (44%) intended to be practising after five years, and 196 (24%) intended to be practising after 10 years. The median indemnity premium in 2001-02 was $35,515 (range, nil to $156,000) for practising obstetricians. The main reasons given for ceasing obstetrics were intention to specialise in gynaecology, fear of litigation, high indemnity costs, family disruption, and long working hours. About two-thirds of respondents (557/818) had experienced the threat of litigation, and almost all (768/803) desired some type of "no-fault" indemnity scheme. Thirty-three of the 314 respondents who had given medicolegal opinions accounted for 71% of the total number of opinions. Many of these were non-practising obstetricians who were not accredited RANZCOG expert witnesses.


CONCLUSIONS
There will soon be a shortage of experienced practising obstetricians in Australia.
MacLennan
Alastair H
AH
Department of Obstetrics and Gynaecology, The University of Adelaide, Women's and Children's Hospital, 72 King William Road, North Adelaide, SA 5006. alastair.maclennan@adelaide.edu.au
Spencer
Michael K
MK
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001315:Australia; D002322:Career Mobility; D005260:Female; D006801:Humans; D007351:Insurance, Liability / Q000191:economics; D008297:Male; D008875:Middle Aged; D009774:Obstetrics; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D000078329:Workforce