How many clinical perinatologists will we need by the next millenium?

OBJECTIVE: To project the number of fulltime clinical Maternal-Fetal Medicine specialists (MFMs) needed to serve the United States population by the year 2001. STUDY DESIGN: The most recent national statistics were polled for projected births over the next 5 years. Manpower projections were derived from current full and associate (nonfellow) SPO membership rolls, and assumed adoption of the recent list of clinical problems specific for MFMs with typical frequencies of their visits per pregnancy, capacity adjustments for longer MFM visits, annualized work-weeks per MFM. These projections were refined for varying levels of managed care market penetration, according to the 1995 Sachs Group models. RESULTS: Of the 3892000 births in 1995, 14% (544880) could qualify for MFM-specific services. Without further changes in marketplace or degree of birthrate decline, by 2001, 3638131 births would occur, requiring 1267 fulltime MFMs. Of the current 1253 MFMs in the US, 45% are community-based (100% clinical) and 55% university-based (80% clinical), an effective fulltime workforce of 1115. Based on annual attrition of current MFMs and addition of new fellowship graduates (80% = full time clinical), a net increase of 206 MFMs would occur by 2001. Adustments for varying penetrations of managed care could reduce MFMs required to a range from 951 to 1065. CONCLUSIONS: Without major restructuring of practice and referral patterns, projected needs for the fulltime MFM workforce by the year 2001 would be clearly exceeded at the anticipated rate of new fellow production.