1997 Publications

Schmidt L.A., Greenberg B.D., Holzman G.B., Schulkin J. Treatment of Depression by Obstetrician-Gynecologists: A Survey Study. Obstetrics and Gynecology 90:296-300, 1997.

We performed an exploratory survey of depression diagnosis, treatment, and patient referral patterns by Fellows of the American College of Obstetricians and Gynecologists (ACOG). Obstetrician-gynecologists' professional training in the management of clinical depression was also surveyed. We sent a questionnaire to a total of 1370 ACOG Fellows. Sixty percent of the surveys were returned. As a group,obstetrician-gynecologists reported diagnosing an average of four new cases of depression per month. Within the overall sample, the number of new diagnoses of depression made each month was significantly greater for those defining themselves as primary care physicians compared to those made by self-defined specialists. When treating depression pharmacologically, obstetrician-gynecologists reported that they overwhelmingly (74% of the time) chose serotonin selective reuptake inhibitor antidepressants (SSRIs). Ninety-five percent of obstetrician-gynecologists reported that they referred severely depressed patients to a mental health professional. A majority of respondents received neither residency training (80%), nor completed a continuing medical education course (60%) on the treatment of clinical depression in women. Studies to further assess obstetrician-gynecologists management of depression and to better define needs for professional education are warranted.

Scroggs J.A., Griffin L.P., Beryl M., Schulkin J. Ob-Gyns as Primary Care Physicians: The Perspectives of HMO Medical Directors and Ob/Gyns.    Obstetrics and Gynecology 90:291-95, 1997.

We surveyed the interest of obstetrician-gynecologists in serving as primary care physicians, and their perceived preparedness for that role from the viewpoint of both managed care plans and obstetrician-gynecologists. We found that obstetrician-gynecologists do not agree on the appropriate and preferred role as physicians in the managed care environment. Some (37%) see themselves as primary care physicians while some (37%) would rather act as consultative specialists. Nearly all, however, support direct access to obstetrician-gynecologists. Most (69.7%) believe they are capable of serving as primary care gatekeepers with little or no additional training. However, managed care plans believe extensive additional training is needed for obstetrician-gynecologists to serve as primary care gatekeepers within their plans.