Could 'red states' see fewer OB/GYNs after the inauguration? Some docs think so.
Key Takeaways
Industry Insights
“Access to lifesaving care like abortion care or LGBTQ healthcare should not be dependent on where you live." - Kate Steinle, Chief Clinical Officer of the digital healthcare company FOLX Health
"Some clinicians will fight to continue to practice because they know it is safe, effective and evidence-based—and some will choose not to put their livelihood or legal standing at risk." - Kate Steinle, Chief Clinical Officer of the digital healthcare company FOLX Health
“In states that restrict or ban abortions, many OB/GYN residents emerge from training without the essential skills in comprehensive reproductive healthcare." - Chew Murphy, MD
As Republicans are poised to take control of all three branches of government, and with an already strong grip on the courts, the country may see a new wave of abortion and LGBTQ+ healthcare restrictions. As it gets harder and riskier to practice medicine, some doctors might consider migrating to states with friendlier legal and legislative climates.
One surgery resident shared an Instagram post discussing whether graduating physicians will even want to take jobs in red states.[] This is currently a huge topic of discussion, the user said, among med students. And of course it is: As politicians restrict access to LGBTQ+ healthcare and abortion services, doctors are being forced to either forego life-saving care or worry about whether their actions could be penalized under state law.
Kate Steinle, Chief Clinical Officer of the digital healthcare company FOLX Health, says we’ve already seen many doctors move out-of-state in response to sweeping abortion restrictions. As a result, patients in these states are left with limited access to safe care. “Access to lifesaving care like abortion care or LGBTQ healthcare should not be dependent on where you live, but that is currently the reality for many people in conservative states,” Steinle says.
Healthcare providers started relocating after Roe V. Wade fell
In the 2022 Dobbs v. Jackson Women’s Health Organization United States Supreme Court case, the Court revoked the constitutional right to abortion that had long been protected under Roe v. Wade.[] In the wake of that ruling, there was a notable decrease in the number of medical students applying to OB/GYN residency programs in states with abortion bans, research shows.[] At the same time, many states have enacted restrictions against providing healthcare services, such as gender-affirming care, to LGBTQ+ patients.[]
Doctors are extremely concerned about the impact that these laws will have on their ability to properly care for patients. For example, a doctor based in Tennessee says that the state’s extreme abortion ban has already forced her to decide between caring for her patients or facing legal ramifications.[]
@tnadvocatesforpp Tennessee’s extreme abortion ban is having devastating effects. Doctors are unable to provide life-saving care because of legal constraints and the risk of consequences. Patients are forced to travel hundreds of miles or wait countless hours to get the care they need, even if their survival is at stake. Hear their stories, take them to heart, and vote to protect the right to reproductive care in Tennessee. Paid for by Tennessee Advocates for Planned Parenthood. Not authorized by any candidate or candidate’s committee. #tennessee #abortionishealthcare #abortionrights #reproductiverights #reproductivehealth #vote #fyp #fypシ ♬ original sound - tnadvocatesforpp
“We have already seen conservative states like Texas seek to criminalize clinicians who provide healthcare to trans youth,” Steinle says. She notes that these attacks on clinicians are designed to instill fear of losing their licenses or being charged with crimes.
“Some clinicians will fight to continue to practice because they know it is safe, effective and evidence-based—and some will choose not to put their livelihood or legal standing at risk, and will either stop providing that care altogether or will move to a less politically conservative state where they can practice with legal protections,” Steinle says.
As restrictions increase, doctors may look for work elsewhere
Recent evidence from The Research and Action Institute, a think tank of the Association of American Medical Colleges found that the number of applicants to emergency medicine and OB/GYN programs in 2024 was lowest in states with strict abortion bans.[] On TikTok, an internal medicine physician, who goes by the username @InternalMedDoc, says that as restrictions increase, red states will likely train fewer OB/GYNS—and that fewer OB/GYNS will stay there in the long term.[]
@internalmeddoctor #greenscreen things will only get worse for women and children in red states. #doctor #fyp #doctorsoftiktok #physician #usa #democrat #republican #obgyn #abortion #abortionrights ♬ Mysterious and sad BGM(1120058) - S and N
Emma Chew Murphy, MD, an OB/GYN and clinical fellow in the Complex Family Planning Fellowship Program at UC San Francisco, doesn’t expect the trend to slow down anytime soon. “With the results of this election, we anticipate continued attacks on abortion rights and, hand-in-hand with these attacks, continued negative impacts on the rates of medical graduates applying for training in states with restrictions or bans,” she tells MDLinx.
OB/GYNs aren’t the only healthcare professionals reconsidering where they work. According to Dr. Chew Murphy, healthcare providers across many specialties are reconsidering where they train and practice. “This decision is driven not only by the value they place on practicing in states where their patients have access to abortion care, but also to ensure access to comprehensive reproductive healthcare for themselves, their partners, or family members,” she says.
If more doctors leave, disparities are expected to increase
Another huge concern among physicians is whether residents will receive adequate training if they learn and work in states that prohibit certain types of healthcare. “Residencies in certain states will have to limit their training programs based on what is legally allowed, ie, no training on abortion or training on abortion care only up to 6 weeks,” Steinle says.
An OB/GYN featured on “60 Minutes” shared that residents training in states with abortion restrictions won’t have opportunities to learn how to diagnose various pregnancy complications in the first and second trimesters.[] They may also miss learning about miscarriage care and ectopic pregnancy care. About a quarter of all OB/GYN residency programs are in near or total ban environments, according to Dr. Chew Murphy. “This creates tremendous hurdles for OB/GYNs to obtain the fundamental skills in order to provide full-spectrum reproductive healthcare,” she says.
If many doctors leave states like Idaho, Florida, and Texas, it will likely become more difficult for patients in these areas to access medical care. The impact will likely be greatest among communities already facing barriers to care, such as those living in rural and low-income areas, as well as people of color, Dr. Chew Murphy adds.
“In states that restrict or ban abortions, many OB/GYN residents emerge from training without the essential skills in comprehensive reproductive healthcare. This will certainly have an impact on the communities where they practice medicine,” Dr. Chew Murphy says.