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Ethical Concerns and Career Satisfaction in Obstetrics and Gynecology: A Review of Recent Findings From the Collaborative Ambulatory Research Network

Farrow, Victoria A. BS*; Leddy, Meaghan A. PhD; Lawrence, Hal MD; Schulkin, Jay PhD§

Obstetrical & Gynecological Survey: September 2011 - Volume 66 - Issue 9 - p 572-579
doi: 10.1097/OGX.0b013e3182391240

Obstetricians-gynecologists (ob-gyns) are frequently confronted with situations that have ethical implications (e.g., whether to accept gifts or samples from drug companies or disclosing medical errors to patients). Additionally, various factors, including specific job-related tasks, costs, and benefits, may impact ob-gyns' career satisfaction. Ethical concerns and career satisfaction can play a role in the quality of women's health care. This article summarizes the studies published between 2005 and 2009 by the Research Department of the American College of Obstetricians and Gynecologists, which encompass ethical concerns regarding interactions with pharmaceutical representatives and patient safety/medical error reporting, as well as ob-gyn career satisfaction. Additionally, a brief discussion regarding ethical concerns in the ob-gyn field, in general, highlights key topics for the last 30 years. Ethical dilemmas continue to be of concern for ob-gyns. Familiarity with guidelines on appropriate interactions with industry is associated with lower percentages of potentially problematic relationships with pharmaceutical industries. Physicians report that the expense of patient safety initiatives is one of the top barriers for improving patient safety, followed by fear of liability. Overall, respondents reported being satisfied with their careers. However, half of the respondents reported that they were extremely concerned about the impact of professional liability costs on the duration of their careers. Increased familiarity with guidelines may lead to a decreased ob-gyn reliance on pharmaceutical representatives and free samples, whereas specific and practical tools may help them implement patient safety techniques. The easing of malpractice insurance and threat of litigation may enhance career satisfaction among ob-gyns. This article will discuss related findings in recent years.

Target Audience: Obstetricians & Gynecologists and Family Physicians

Learning Objectives: After the completing the CME activity, physicians should be better able to analyze how interactions with pharmaceutical industry may pose ethical dilemmas, examine current barriers to implementing patient safety initiatives, and evaluate the factors that influence career satisfaction among obstetrician-gynecologists.

*Research Associate, American College of Obstetricians and Gynecologists, Washington, DC and ACOG Doctoral Candidate, Department of Psychology, American University, Washington, DC; †Research Associate, American College of Obstetricians and Gynecologists, Washington, DC; ‡Executive Vice President, American College of Obstetricians and Gynecologists, Washington, DC; and §Director of Research, Department of Psychology, American University, Washington, DC

Chief Editor's Note: This article is part of a series of continuing education activities in this Journal through which a total of 36 AMA/PRA Category 1 Credits TM can be earned in 2011. Instructions for how CME credits can be earned appear on the last page of the Table of Contents.

Unless otherwise noted below, each faculty's and staff's spouse/life partner (if any) has nothing to disclose.

The authors have disclosed that this research was performed under an appointment to the Department of Homeland Security (DHS) Scholarship and Fellowship Program, administered by the Oak Ridge Institute for Science and Education (ORISE) through an interagency agreement between the U.S. Department of Energy (DOE) and DHS. ORISE is managed by Oak Ridge Associated Universities (ORAU) under DOE contract number DE-AC05-06OR23100. All opinions expressed in this paper are the author's and do not necessarily reflect the policies and views of DHS, DOE, or ORAU/ORISE.

Sources of funding: The study was supported by Maternal and Child Health Bureau (Title V, Social Security Act, grant R60-MC-05674), Health Resources and Services Administration, Department of Health and Human Services.

Correspondence requests to: Jay Schulkin, PhD, American College of Obstetricians and Gynecologists, Research Department, 409 12th Street, SW Washington, DC 20024. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.