Most OBGYNs work in one of two places: a physician’s office or a hospital. Bureau of Labor Statistics data from 2023 shows roughly 13,530 OBGYNs employed in physician office settings compared to about 4,290 in general medical and surgical hospitals. But those two broad categories mask a wide range of day-to-day environments, from solo clinics to fertility centers to military medical facilities. Here’s what each setting actually looks like.
Private Practice and Group Clinics
The physician’s office is the single largest employer of OBGYNs in the United States, and most of these offices are group practices rather than solo operations. About 46.3% of OBGYNs work in some form of private practice, according to American Medical Association data, though that share has been declining for years as more physicians move into employed positions with hospitals or large health systems.
In a typical office-based practice, an OBGYN splits time between routine gynecologic care (annual exams, contraception counseling, Pap tests, managing conditions like endometriosis or abnormal bleeding) and prenatal visits for pregnant patients. The trade-off is that office-based OBGYNs often still take call at a nearby hospital for their patients’ deliveries, which means unpredictable overnight pages and interrupted clinic days. Group practices help with this by sharing call duties, so one physician covers the hospital while partners stay in the office.
Solo practice has become increasingly rare across all specialties. Larger groups offer practical advantages: shared on-call schedules, pooled administrative costs, and easier adoption of electronic health records. Patients in group practices generally accept that a different doctor from the same group may handle their delivery or surgery, trusting the team rather than a single provider.
Hospitals and Labor and Delivery Units
Hospital-based OBGYNs fall into two main categories. Some are traditional OBGYNs who split their week between an office and the hospital, heading in for scheduled surgeries or when a patient goes into labor. Others are OB hospitalists, physicians who work exclusively inside the hospital on a shift-based schedule.
OB hospitalists handle whatever comes through the door during their shift: emergency cesarean deliveries, complicated births, postpartum hemorrhage, and unassigned patients who arrive at the emergency department. They also provide backup for office-based OBGYNs who can’t reach the hospital in time for a delivery. At teaching hospitals, hospitalists often supervise residents and medical students and work alongside certified nurse-midwives and family physicians who deliver babies.
The hospitalist model has grown in popularity partly because the schedule is more predictable. Shifts have defined start and end times, compensation is competitive, and benefits like guaranteed time off are built in. For physicians who enjoy the intensity of inpatient obstetrics but want to avoid managing a business, it’s an appealing alternative to private practice. Practicing solely in the hospital also keeps certain hands-on skills sharp, like forceps-assisted delivery and managing twin births.
Ambulatory Surgery Centers
A growing number of gynecologic procedures happen in outpatient surgery centers rather than hospital operating rooms. These freestanding facilities handle same-day procedures that don’t require an overnight stay, and they typically cost less for patients and insurers than hospital-based surgery.
Common procedures performed in these centers include hysteroscopy (examining the inside of the uterus and taking tissue samples), fibroid removal, treatment for heavy menstrual bleeding, tubal ligation for permanent birth control, cervical cone biopsies to evaluate abnormal screening results, bladder repair for urinary leakage, and surgical management of miscarriage. An OBGYN working in this setting may operate several days a week with a more predictable schedule than a hospital-based surgeon, since all cases are planned in advance and emergencies are rare.
Academic Medical Centers
OBGYNs at university-affiliated hospitals juggle patient care, teaching, and research, though the balance tips heavily toward clinical work. Clinical faculty typically spend 70% to 75% of their time seeing patients and only 25% to 30% on everything else, especially at earlier career stages. In practice, the “academic time” that’s supposed to go toward research or teaching often gets absorbed by administrative tasks and catching up on patient notes.
Academic OBGYNs are more likely to subspecialize and to see complex or unusual cases referred from community physicians. They also train the next generation of OBGYNs by supervising residents in clinic, in the operating room, and on the labor floor. For physicians drawn to research or teaching, the academic path offers opportunities that don’t exist in private practice, but the clinical workload is still substantial.
Fertility Clinics
OBGYNs who complete additional fellowship training in reproductive endocrinology and infertility work primarily in outpatient fertility clinics, a setting that looks and feels very different from a typical OBGYN office. Mornings typically start with “monitoring,” where dozens of patients undergoing fertility treatments come in for blood draws and ultrasounds to track their cycle. One reproductive endocrinologist described seeing up to 50 patients in a two-hour monitoring window.
The rest of the day shifts between office consultations (new patients, follow-ups for conditions like polycystic ovary syndrome, discussions about egg or embryo freezing) and procedural work like IVF egg retrievals, embryo transfers, and laparoscopic surgery. Because fertility treatment is tied to patients’ menstrual cycles, most clinics are open 364 days a year. Workweeks average around 50 hours, with weekend call roughly every four to six weeks. The setting is almost entirely outpatient, which is a significant departure from the hospital-heavy training of medical school and residency.
Community Health Centers
Federally Qualified Health Centers serve underserved communities and are an important access point for prenatal and gynecologic care, particularly for patients who are uninsured or on Medicaid. OBGYNs in these clinics focus on prenatal visits, postpartum care, and routine gynecologic services like screenings and contraception.
Many community health centers partner with OB hospitalist groups at nearby hospitals. The arrangement works like this: clinic-based providers handle all the outpatient prenatal and postpartum care, while hospital-based OBGYNs manage the deliveries and any obstetric emergencies. This division lets clinic physicians see more patients who need services without being pulled away for unpredictable hospital time. For communities with growing populations and limited provider availability, this model helps more patients get into the system and receive consistent care throughout pregnancy.
Government and Military Facilities
The Department of Veterans Affairs employs OBGYNs (specifically gynecologists, since the VA patient population rarely needs obstetric care) across its network of medical centers and specialty clinics. Women are the fastest-growing group of veterans in the U.S., and VA gynecologists provide pelvic exams, cancer screenings, infection testing and treatment, and management of conditions like endometriosis, ovarian cysts, and chronic pelvic pain. Some also work in VA Community Living Centers that serve aging veterans.
Active-duty military OBGYNs practice in military hospitals and clinics both domestically and overseas, providing the full scope of obstetric and gynecologic care to service members and their families. These positions are salaried with full military benefits, and the patient population skews younger than in most civilian practices.
Telehealth as a Growing Work Setting
Telehealth isn’t a physical location, but it has become a meaningful part of where OBGYN care happens. Virtual visits in OB/GYN went from under 1% of all visits to 17% during the early pandemic period, and usage has since stabilized at roughly 9% to 12% of services in high-income countries. Video and phone consultations accounted for 60% to 90% of prenatal and postpartum visits during the pandemic’s peak.
Remote care has proven effective for several specific situations. Home blood pressure monitoring paired with telehealth check-ins increased early detection of preeclampsia by 22%. Management of gestational diabetes through mobile glucose tracking showed outcomes comparable to in-person care. Text message reminders boosted postpartum follow-up compliance by 26% and breastfeeding initiation by 15% to 20% in some programs. For younger patients, 41% of adolescent women in one study preferred virtual consultations for contraception. Most OBGYNs who use telehealth integrate it into an office-based or hospital-based practice rather than working exclusively online.