Thesis #6 — You cannot legislate the practice of medicine into a felony and expect physicians to remain.
It takes twelve years to make an OB/GYN. The single strongest predictor of where a physician practices for the rest of their career is where they completed residency. The pipeline is what we call the workforce. It cannot be rebuilt in a budget cycle.
The pipeline is breaking now.
OB/GYN residency applications in ban states are already negative — two cycles running. In Idaho, an estimated 35% of obstetric physicians stopped practicing between 2022 and 2024.
The replacements are not coming.
Dobbs did not just ban abortion in certain states. It introduced felony-prosecution risk into the practice of emergency obstetrics. The medicine does not change. The fear does. The fear is what drives the exodus — and the exodus is what closes the labor and delivery unit two counties over.
What I do not think about during the case is the workforce composition that put the team in the room. What I think about, an hour later, writing the operative note, is who would have done the case if the team had not been here.
The team was there today. The Signal is about whether that is still true in 2032.
Read the full series:
You can read me anywhere. There are louder takes. There are faster newsfeeds. There are bigger names. What you get here that you don’t get anywhere else is THE SPINE — a permanent argumentative scaffold you can stand on, walk along, share with the people you’re trying to convince, and keep coming back to over years.
The reason your premium went up $1,000. The reason your sister’s cancer trial got pulled. The reason Pap smears are disappearing from rural counties.
THEY ARE THE SAME REASON.
That’s the case we’re making, week after week, until the country can see it.
Thank you for being here. Forward this to one person who needs the spine.
— YC
Founder & CEO, Diosa Ara | Creator & Editor-in-Chief, The Labora Collective
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