The obstetrics and gynecology (OB-GYN) physician workforce plays a critical role in meeting a wide range of women’s health needs, including maternity care and gynecologic services such as preventive screenings. The lack of available and accessible maternity care is a risk not only at the time of delivery but throughout the birthing journey. Nationwide in 2021-2022, there were 3.8 OB-GYNs for every 10,000 women, according to KFF. Workforce challenges in obstetrics and gynecology can be especially acute in mostly rural states such as Arkansas, which has one of the highest maternal mortality rates in the nation. Recent closures of hospital and obstetric units in Arkansas and around the U.S. also contribute to these challenges.
To better understand the state of OB-GYN care, we have created an interactive dashboard to examine this workforce in Arkansas for the years 2019 through 2022. The dashboard provides visualizations at the state, county, and regional levels and includes information on physician demographics and activity status (full-time, part-time), and payer mix.
Key findings based on data for 2022, the most recent year available, include:
- 10 counties had no active OB-GYNs.
- There were 272 active OB-GYNs in the state, or 3.2 per 10,000 women ages 12-55 residing in Arkansas (based on National Center for Health Statistics population estimates).
- About 25% of OB-GYNs were active fewer than 150 days during the year. An “active day” is defined as a day in which the physician provided services to at least two female patients or performed a qualifying procedure.
- 23% of full-time OB-GYNs were 60 or older, raising concerns about future supply as many approached retirement.
- Early-career OB-GYNs (under age 45) were more likely to practice full-time during the year compared to OB-GYNs age 45 and up (88% vs 68%).
- The OB-GYN workforce overall was 53% male and 47% female, but among physicians under age 45, 3 out of 4 were women.
- While Black and Hispanic Arkansans made up 14.9% and 8.8%, respectively, of the state’s population, they represented only 7% and 2%, respectively, of active OB-GYNs.
The dashboard is intended to inform policymakers, healthcare leaders, and other stakeholders about the supply, characteristics, and distribution of OB-GYNs so they can make evidence-based decisions regarding provider access across Arkansas communities.
About the Data
The data presented in this dashboard were obtained from the Arkansas Healthcare Transparency Initiative’s All-Payer Claims Database, licensure files from the Arkansas State Medical Board, and CarePrecise.
To be included in the dashboard, a physician must:
- Hold a valid Arkansas medical license and National Provider Identifier (NPI).
- Be assigned a specialty of obstetrics, gynecology, or combined OB-GYN.
- Have had at least one active day during the year, with an “active day” defined as a day in which the physician did at least one of the following (a patient is considered to fall within the specified age range if she was within that range at any point during the calendar year):
- Provided evaluation and management services to at least two female patients ages 12-55 in Arkansas.
- Performed a qualifying procedure (e.g., a delivery) for a female patient age 12-55 in Arkansas.
Physician activity levels are based on the number of active days per year:
- Full time: 150 or more active days
- Part time: 50-149 active days
- Limited time: 11-49 active days
- Very limited time: 1-10 active days
Specialty assignments were based on information from physician licensure files. In cases where NPIs or license numbers were missing, CarePrecise were used to obtain the missing information. Manual review was conducted when necessary to assign specialty designations.
DEMOGRAPHICS VIEW
Demographic information was obtained from licensure data.
Payer mix visualizations reflect the distribution of each physician’s patients by primary payer type (e.g., Medicaid, Medicare, commercial insurance). Each bar represents an individual physician and shows the number of patients seen or visits provided during the calendar year. Only services delivered to females ages 12-55 are included. Suppression rules are applied to prevent disclosure of small numbers. Counts fewer than 11 are suppressed and displayed as 1.
GEOGRAPHIC VIEW
Geographic views on the dashboard are available at several levels:
- Statewide (all physicians meeting inclusion criteria).
- County of service location.
- Marketplace regions used by the Arkansas Insurance Department.
- University of Arkansas for Medical Sciences regional campuses and training sites.
- Rurality, based on the 2023 Rural-Urban Continuum Codes (RUCC), which distinguish counties by population size and proximity to metropolitan areas. Urban counties were defined by RUCC codes 1-3. Rural counties were defined by RUCC codes 4-9.
Counts of active physicians and activity classifications may differ between state and county views because activity is calculated separately at each level. For example, a physician may be full time at the state level but part time in a specific county, depending on where the physician’s active days occurred. A small number of physicians could not be assigned to a specific county.