Testing for sexually transmitted diseases—namely, chlamydia and HPV—also ranks high on the list of most frequently ordered diagnostic tools. Respondents reported that they order tests for chlamydia and HPV an average of 21 and 20 times per week, respectively.

Substance abuse testing and fetal fibronectin (fFN) screening topped the list of tests that ob/gyns would order in the future. An increase in testing for drug abuse could ultimately minimize the risk of infant mortality and morbidity. Additionally, a couple of respondents recognized that screening for fFN helps them improve patient care by decreasing concerns about preterm labor.

Genetic testing—for purposes other than prenatal use—was cited by four out of 25 respondents as a diagnostic tool they would order in the future. Nearly seven out of 50 respondents reported that they would order urodynamic testing. Several physicians noted that urologic testing would not only be beneficial to patients, but would also generate income for their practices.

Where's the money going?

Ob/gyns plan to spend more than $18,000 on new equipment for their practices this year, according to the survey. That's about three times as much as the amount they projected spending in 2001. While 43% of ob/gyns said their 2005 budget for new equipment remained the same as in 2004, more than a third reported their current budget has decreased. Less than a quarter saw an increase in their budget for new devices.

TABLE 3 What kind of equipment do ob/gyns use?

Although respondents said they used computers and software most often in their offices—an average of 30 times and 27 times per week, respectively—their top purchases this year will be catheters and sutures (Table 3). Next on the shopping list are cervical samplers—28% said they would make a new or replacement purchase in 2005.

FIGURE 1 Sources of new medical product and equipment information

So where are physicians finding information on new products? Medical journals, reported 75% of respondents (Figure 1). Colleagues (72%), sales representatives (68%), seminars or conferences (64%), and company literature (63%) are other top sources. Notably, since 2000, more ob/gyns now rely on CD-ROMs for new product information than the Internet or online databases and video or audio cassettes.

Once they learn about a new product, ob/gyns aren't quick to pull out their credit cards. Nearly three quarters wait at least 7 months to purchase a new device, and almost half do so 1 or 2 years after it is on the market. In contrast, just 1% of ob/gyns said they would purchase a new devise as soon as it was available.

The driving motivator for purchasing new equipment was to help meet the current standard of care, reported more than half of respondents. Almost three out of 10 cited a device's ability to drive revenue as another reason to buy, and nearly a quarter identified cost as a factor in their purchasing decisions.

Technology's impact: now and beyond

FIGURE 2 New medical technology that has already had the most impact on ob/gyns practice

When asked what device introduced in the last few years had the most impact on their practice, nearly one out of five ob/gyns cited the new 3D/4D U/S (Figure 2). One male ob/gyn in a group practice in the West noted that he adopted the device, "because patients were continually asking about it." This demand suggests that acquiring the 3D/4D U/S has the potential to increase profits, as well. For one male ob/gyn from the East, who sees about 40 patients in a typical week, adopting a 3D/4D U/S was a positive choice for him and his partner "financially as well as in patient satisfaction."

Almost one out of 10 ob/gyns cited NovaSure ablation as another significant acquisition to their practices in recent years. Several physicians noted the device's effectiveness in controlling bleeding and avoiding hysterectomy. A male physician in group practice in the Midwest listed the device's other advantages: "easy to learn, high success (rate), good compensation, and short duration of procedure."

Next on the list were devices for loop electrosurgical excision procedures (LEEP), cited by 8% of ob/gyns as having already had an impact on their practices. Several physicians noted that these devices are more "convenient," allowing them to perform the procedure in the office rather than the hospital.

The top medical device that ob/gyns plan to adopt in the future is a bone densitometer. According to an ob/gyn from the South, who sees about 150 patients per week, an aging population and an increased awareness about osteoporosis make this piece of equipment a good future purchase. Already this piece of equipment has made inroads within ob/gyns' practices. According to one physician from the Midwest, who has already adopted this technology, he saw a "good response from patients and higher compliance and higher revenue."

FIGURE 3 New technology ob/gyns think will have the most impact on their future practice

Ob/gyns surveyed also believe that in-office endometrial ablation and EMRs will have a future impact on their practices (Figure 3). Patient demand and effectiveness make endometrial ablation a popular acquisition in the near future, while the promise of fewer medical errors may make EMRs a good buy. Still, at least one ob/gyn—a solo practitioner from the South—noted that the purchase of EMRs has an upside and a downside: The cost of converting written records into EMRs will have a negative impact on practices not already using this technology, but ultimately will provide for better management of records.

As technology continues to pervade the practice of medicine, ob/gyns will have to keep up with the latest advancements. These technological developments not only benefit office-based practices in terms of patient satisfaction and increased revenue, but also can help improve the quality of obstetric and gynecological care.

REFERENCES

1. U.S. Department of Health & Human Services. "Fact sheet: Harnessing information technology to improve health care." May 6, 2004. http://www.hhs.gov/news/press/2004pres/20040427a.html. Accessed August 31, 2005.