Who Provides? Clinician and Trainee Perspectives on Reproductive Healthcare Access in Vermont

谁来提供服务?佛蒙特州临床医生和实习医生对生殖健康服务的看法

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Abstract

OBJECTIVE: To assess Vermont primary care provider (PCP) willingness to expand scope of practice to meet rising reproductive healthcare demands following the 2022 Dobbs decision and evaluate the decision's longitudinal implications for workforce development. STUDY SETTING AND DESIGN: We conducted a cross-sectional, statewide survey of Vermont PCPs and medical trainees in December 2024. Participants were identified via databases maintained by the University of Vermont (UVM) Office of Primary Care and Area Health Education Center Program and the UVM Larner College of Medicine. DATA SOURCES AND ANALYTIC SAMPLE: Data were obtained via survey responses and categorized by professional role, training level, and specialty. Statistical associations were assessed using Chi-Square tests. PRINCIPAL FINDINGS: Over three quarters of Vermont PCPs (77/103, 75%; 95% CI 67%-83%) are willing to expand their scope to ensure safe access to reproductive care. Provision of medication abortion, miscarriage management, and long-acting reversible contraceptives were identified as areas for scope expansion. Trainees and younger providers were less willing to practice in states with restrictive abortion policies (89/110, 81%; 95% CI 74%-88%) or limited family planning services (90/110, 82%; 95% CI 75%-89%). CONCLUSIONS: Reproductive healthcare policy significantly influences provider career decisions with implications for workforce development in abortion-restricted states.

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