title: The economic impact of rural family physicians practicing obstetrics.
abstract: BACKGROUND
  The economic impact of a family physician practicing family medicine in rural Alabama is $1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986.
  
  
  METHODS
  Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed.
  
  
  RESULTS
  Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%.
  
  
  CONCLUSIONS
  A family physician practicing obstetrics in a rural area adds an additional $488,560 in economic benefit to the community in addition to the $1,000,000 from practicing family medicine, producing a total annual benefit of $1,488,560. The investment of $616,385 from the Alabama Family Practice Rural Health Board resulted in a $399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was $246,047,120.
authors.affiliation: From the Department of Obstetrics & Gynecology, College of Community Health Sciences, The University of Alabama, Tuscaloosa (DMA, DEH, JTM); the College of Community Health Sciences, The University of Alabama, Tuscaloosa (MWL); the Department of Community & Rural Medicine, Institute for Rural Health, The University of Alabama, Tuscaloosa (MTT); and the Department of Information Systems, Statistics and Management Science, Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa (JMP). davery@cchs.ua.edu.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Avery
authors.affiliation: From the Department of Obstetrics & Gynecology, College of Community Health Sciences, The University of Alabama, Tuscaloosa (DMA, DEH, JTM); the College of Community Health Sciences, The University of Alabama, Tuscaloosa (MWL); the Department of Community & Rural Medicine, Institute for Rural Health, The University of Alabama, Tuscaloosa (MTT); and the Department of Information Systems, Statistics and Management Science, Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa (JMP).
authors.forename: Dwight E
authors.initials: DE
authors.lastname: Hooper
authors.affiliation: From the Department of Obstetrics & Gynecology, College of Community Health Sciences, The University of Alabama, Tuscaloosa (DMA, DEH, JTM); the College of Community Health Sciences, The University of Alabama, Tuscaloosa (MWL); the Department of Community & Rural Medicine, Institute for Rural Health, The University of Alabama, Tuscaloosa (MTT); and the Department of Information Systems, Statistics and Management Science, Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa (JMP).
authors.forename: John T
authors.initials: JT
authors.lastname: McDonald
authors.affiliation: From the Department of Obstetrics & Gynecology, College of Community Health Sciences, The University of Alabama, Tuscaloosa (DMA, DEH, JTM); the College of Community Health Sciences, The University of Alabama, Tuscaloosa (MWL); the Department of Community & Rural Medicine, Institute for Rural Health, The University of Alabama, Tuscaloosa (MTT); and the Department of Information Systems, Statistics and Management Science, Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa (JMP).
authors.forename: Michael W
authors.initials: MW
authors.lastname: Love
authors.affiliation: From the Department of Obstetrics & Gynecology, College of Community Health Sciences, The University of Alabama, Tuscaloosa (DMA, DEH, JTM); the College of Community Health Sciences, The University of Alabama, Tuscaloosa (MWL); the Department of Community & Rural Medicine, Institute for Rural Health, The University of Alabama, Tuscaloosa (MTT); and the Department of Information Systems, Statistics and Management Science, Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa (JMP).
authors.forename: Melanie T
authors.initials: MT
authors.lastname: Tucker
authors.affiliation: From the Department of Obstetrics & Gynecology, College of Community Health Sciences, The University of Alabama, Tuscaloosa (DMA, DEH, JTM); the College of Community Health Sciences, The University of Alabama, Tuscaloosa (MWL); the Department of Community & Rural Medicine, Institute for Rural Health, The University of Alabama, Tuscaloosa (MTT); and the Department of Information Systems, Statistics and Management Science, Culverhouse College of Commerce and Business Administration, The University of Alabama, Tuscaloosa (JMP).
authors.forename: Jason M
authors.initials: JM
authors.lastname: Parton
mesh_terms: D000407:Alabama; D004470:Economics, Medical; D005257:Fellowships and Scholarships / Q000191:economics; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008427:Maternal Health Services / Q000191:economics* / Q000600:supply & distribution; D008484:Medicaid / Q000191:economics; D008507:Medically Underserved Area; D009774:Obstetrics / Q000191:economics* / Q000193:education; D010821:Physicians, Family / Q000191:economics* / Q000193:education; D011247:Pregnancy; D015397:Program Evaluation; D012052:Reimbursement, Incentive; D019035:Rural Health Services / Q000191:economics*; D012456:Salaries and Fringe Benefits; D014481:United States; D000078329:Workforce
keywords: Health Care Economics and Organizations; Obstetrics; Rural Health