Relocation of obstetrician-gynecologists in the United States, 2005-2015

Objective: To examine recent trends in the relocation of obstetrician-gynecologists (ob-gyns) in the United States. METHODS: This longitudinal descriptive study analyzed relocation patterns of ob-gyns between the earliest reference point (2005) and most recently (2015). A physician's county location in a year was compared with his or her location during the previous year. Physician background and county characteristics came from three data resources (Association of American Medical Colleges databases, American Medical Association Physician Masterfile, American Community Survey). A multilevel logistic regression model was used to model factors associated with relocation for the entire period. RESULTS: An average of 2,446 (6.5%) of the 37,385 obgyns in practice moved per year. Approximately one third (32.1%) relocated (usually once or twice) during the 10 years with more than half (58.2%) remaining within their state. The odds of relocating were higher if the ob-gyns was young, male, black, or an international medical graduate. Relocations were predominantly to counties that were either urban or with a lower percentage of the population in poverty (less than 21.2%). Although the number of ob-gyns and women 18 years or older increased in most states, the population to ob-gyn ratio increased from 3,155 in 2006 to 3,293 in 2015. Net gains from relocations were most apparent in Florida, California, and Washington, whereas net losses were especially apparent in Michigan, Pennsylvania, Ohio, Illinois, and New York. CONCLUSION: Approximately one in every three obgyns in the United States moved at least once in the past 10 years to counties that were predominantly urban or with less poverty. Observing this trend might contribute to a better understanding about the uneven national distribution of ob-gyns.