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Five Years Later: Assessing the Impact of Reproductive Health Clinical Training and Post-Graduate Support Services

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5_years_laterWe at RHAP have always known that just because clinicians are trained in abortion care doesn’t mean they will provide abortion care.  Whether or not clinicians can provide this care rests on many factors including:  where the individual practices are located, the support of their colleagues, the ability to access the right equipment and supplies, funding restrictions, and state laws.

In 2007 RHAP launched the Family Medicine Reproductive Health Network to help family physicians trained in abortion care actually provide abortion care. Whatever obstacle they encountered, we try to figure out a way around it to increase the number of family physicians providing abortion care and to expand abortion access to women in need.

One of the first things we did to build the Network was to systematically connect with every family physician who received abortion training.   Working together with the small, but growing, number of residency programs that offer abortion training to family medicine residents and with the reproductive health centers that provide this training across the country, we send a survey every spring to nearly every family medicine resident trained in abortion care. The residents tell us about their training and future plans, and we, in turn, share our tools and resources with them and link them to Network mentors who help them as they start their clinical practices.   Those residents interested in providing abortion care as part of their future practice join our Network.

Since 2007 we have added more than 325 newly trained family physicians to our Network.

Several years after launching the Network, we wanted to know whether our approach was working.  Have our mentoring and support services actually helped clinicians become abortion providers?

To answer that question, RHAP developed another survey in which we ask our Network members, five years after graduation, how their residency training and our efforts have affected the care they provide.  The 2007 family physician graduates were surveyed in October 2012, and although the number of physicians surveyed was fairly small, we feel heartened and hopeful that the help they received has led to their growing role in providing comprehensive reproductive health care and that our work is making a difference.

Here are some highlights from the first cohort of family physicians responding to our 5-year follow-up survey:

Most of the family physicians are providing community-based primary care, and most work in community health centers.

A fifth (21%) of the physicians who responded to our survey are providing abortion care as part of their regular clinical practice.  Another 15%, unable to provide abortion care in their primary clinical practice, work part-time in secondary jobs where they provide abortion care.  Overall, more than one-third of the physicians provide abortion care.

All of the physicians who provide abortion as part of their primary clinical practice work in federally funded community health centers—a challenge to our long-held view that working at a federally funded community health center would pose a huge obstacle to providing abortion care.

70% of the physicians are treating early pregnancy loss.  This means that they are using their abortion skills (manual vacuum aspiration, ultrasound, and medication management) to manage miscarriage—even if they aren’t able to provide abortion care.

100% of the family physicians are offering a wide range of contraceptive options, including IUDs, at their primary clinical sites and 100% offer patient-centered options counseling.

86% are involved in clinical training.  This means that their reproductive health clinical training is being passed on to the next generation of clinicians.

80% of the respondents indicated that they had received help from RHAP and the Family Medicine Reproductive Health Network.  Just about all of them had accessed our website, use our patient education materials and clinical protocols, and subscribe to the Contraceptive Pearls.  30% reported receiving individualized technical assistance from us.

This is just the beginning.  Over the next few years, as we reach out to more of our Network members, we’ll have a better sense of how abortion training and our efforts are changing the landscape of reproductive health care in this country.  In the meantime, we’re thrilled that our efforts to bring more training and opportunities to committed physicians are starting to make a difference in women’s lives.

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