Abortion Provision Among Family Physicians Underrepresented in Medicine

Abstract

Background and Objectives: Workforce diversity in primary care is critical for improved health outcomes and mitigation of inequities. However, little is known about the racial and ethnic identities, training histories, and practice patterns of family physicians who provide abortions. Methods: Family physicians who graduated from residency programs with routine abortion training from 2015 through 2018 completed an anonymous electronic cross-sectional survey. We measured abortion training, intentions to provide abortion, and practice patterns, and examined differences between underrepresented in medicine (URM) and non-URM physicians using χ2 tests and binary logistic regression. Results: Two hundred ninety-eight respondents completed the survey (39% response rate), 17% of whom were URM. Similar percentages of URM and non-URM respondents had abortion training and had intended to provide abortions. However, fewer URMs reported providing procedural abortion in their postresidency practice (6% vs 19%, P=.03) and providing abortion in the past year (6% vs 20%, P=.023). In adjusted analyses, URMs were less likely to have provided abortions after residency (OR=.383, P=.03) and in the past year (OR=.217, P=.02) compared to non-URMs. Of the 16 noted barriers to provision, few differences were evident between groups on the indicators measured. Conclusions: Differences in postresidency abortion provision existed between URM and non-URM family physicians despite similar training and intentions to provide. Examined barriers do not explain these differences. Further research on the unique experiences of URM physicians in abortion care is needed to then consider which strategies for building a more diverse workforce should be employed.