Do maternal-fetal medicine practice characteristics influence high-risk referral decisions by general obstetrician-gynecologists?

Objective : To determine whether the decision of the general obstetrician-gynecologist to refer high-risk obstetric patients depends on the type of practice of the maternal-fetal medicine (MFM) specialist. Methods : A questionnaire was mailed to 935 general obstetrician-gynecologists who were asked whether the MFM specialist's practice characteristics would influence their decision to refer their high-risk obstetric patients. Potential MFM practice components presented in the survey included: MFM, high-risk obstetrics, low-risk obstetrics or general obstetrics and gynecology. Results : A total of 140 (15%) general obstetrician-gynecologists responded, 110 of whom were practicing obstetrics. Of the practicing responders, 77% stated that they were more likely to refer their high-risk obstetric patients if the MFM specialist practiced only MFM and high-risk obstetrics; 69% were less likely to refer their patients when the MFM specialist, in addition to MFM, practiced general obstetrics; and 75% were less likely to refer their patients when the MFM specialist also practiced general obstetrics and gynecology. The MFM practice setting (university vs. community hospital vs. private practice), as well as the geographic location and years of practice of the respondents, did not influence the general obstetrician-gynecologists' decision to refer their high-risk obstetric patients. Conclusion : General obstetrician-gynecologists are more likely to refer high-risk obstetric patients if the MFM specialist practiced only MFM and high-risk obstetrics.