The South Atlantic Association of Obstetricians and Gynecologists (SAAOG) is a regional group of approximately 450 physicians, which was established in 1938. The stated purposes of the association relate to encouraging research, improving quality, cooperation with similar organizations, recognition, and comradeship. During approximately the past 10 years the SAAOG has experienced a decline in terms of the number of active members ( Figure ), new member recruitment, meeting attendance, and submission of abstracts. My address focuses on possible reasons for this decline and potential remedies.

Active membership

South Atlantic Association of Obstetricians and Gynecologists active membership.

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Hoffman. Value, past and future. Am J Obstet Gynecol 2010 .

Reevaluating our association and its recent unfavorable trends leads to some questions. Why would a physician want to be part of the SAAOG? What was the value of this association in the past? What has changed to bring about the waning interest? What will, or better yet what should the value of the SAAOG be in the future?

“Why” and “value” are related questions. Tangible reasons for being part of the SAAOG include continuing medical education (CME); receipt of the American Journal of Obstetrics and Gynecology ; opportunities to learn about, present, and discuss current research; collegiality; career advancement; direct participation in organized medicine; and insight into the future directions of our specialty. There are intangible reasons as well, such as being part of venerable tradition, travel, fun, friendship, inclusion of family, mentorship, prestige, and experiencing generational change and the cycle of life in the specialty.

The decline that SAAOG has experienced is not unique and is at least partially explained by some general trends in both medicine and the economy. Like the rest of the population, the SAAOG has an increasing proportion of senior members. Slow to recruit women and minorities, we have become an association of old white men. We are not an attractive group to prospective young candidate members. While rigorous evidence is lacking, the economy has clearly had a major negative impact on our and other medical societies. Beginning in the late 1980s substantial changes in medical reimbursement and more recently a dramatic decline in the general economy have eroded physician and academic departmental incomes. In both the private and academic sectors this has resulted in an increased emphasis on clinical productivity. Funding for medical meetings and societies has become increasingly restricted and such pursuits are now generally viewed as luxury items. Physicians who are pressed to be clinically productive and have few opportunities to attend medical meetings are probably more likely to focus on concrete types of CME; a medical meeting that is mainly composed of scientific presentations may also more likely be viewed as a luxury item. The shift in obstetrics and gynecology over the past 20 years to a female-dominated specialty may also be impacting the SAAOG. Despite this shift, the association has not recruited a comparable proportion of female members. Forty-nine percent of the fellows and 75% of the junior fellows of the American College of Obstetricians and Gynecologists are women. In contrast, 4% of the SAAOG senior members and 26% of the active members are women. Beyond sex, the newer generation of obstetrician-gynecologists may differ in other ways from the old guard. Medicine is seen more often as a vocation rather than a way of life, with greater emphasis placed on a balanced life. These various factors have probably all contributed toward making the SAAOG a less affordable, less attractive, lower priority medical society.

What steps must the SAAOG take to survive as an organization? We have to ask ourselves whether there is grassroots support for our association. The answer is not clearly yes. The would-be grassroots supporters of SAAOG are the members we have and those (especially younger) obstetrician-gynecologists in the South Atlantic region who we hope would have an interest in membership. Are there steps our organization could take to revitalize itself with grassroots support? The answer is yes. There are some obvious steps we need to take. Other things need to be done that are not as obvious but we need to work to identify and address the issues.

The SAAOG clearly needs an infusion of new young members. This might be accomplished through a combination of greater effort on the part of the current membership, becoming more attractive to prospective members as an organization, and greater flexibility regarding fulfilling candidate membership requirements. We clearly need a greater diversity of people in the membership in terms of sex, race, ethnic background, types of medical practice, and interests. Our organization needs to form closer ties to the training programs in the South Atlantic region so that we can continue to involve residents in our programs, can improve the ability to recognize young and productive faculty as prospective members, are more in tune with the obstetrics and gynecology resident and medical student education programs within our region, and reestablish ourselves as a premier academic obstetrics and gynecology society. While attempting to move forward with revitalization efforts, we need to preserve the unique and special aspects of the SAAOG as a hybrid of outstanding academic and private practitioners.

Reevaluation of standard operating procedures of the SAAOG deserves a few comments. Beginning in 2001 we began to have a topic-based CME program at the start of our annual meeting. This has been a popular addition and many members have voiced the desire to expand the role of educational lectures during the meetings. Based on this and the preceding comments, it appears that we should reevaluate our annual meeting content and potentially find a different balance between scientific and purely educational presentations. Subspecialties are disproportionately represented during the scientific sessions and the association may need to give this consideration relative to the interests of the membership at large. The requirement for a candidate member to give (or do a formal discussion of) a scientific presentation from the podium seems to have become a substantial obstacle to the recruitment of new membership. The SAAOG has created some new options including poster format and allowing a past presentation to our society (eg, as a resident) to be counted as fulfilling this obligation. This is a difficult issue as the podium presentation has been part of what has defined the character of our membership. Our annual meetings are expensive. Given the trend and forecast for the medical economy, a general reduction in funding for medical meetings, the financial pressures that young members and prospective members often face, and the fixed income of the expanding population of senior members, the SAAOG needs to seriously consider more economical venues for the annual meetings. In order for the society to become more attractive to younger (and especially female) obstetrician-gynecologists, we need to consider meeting sites and social programs that are more family-oriented. Cost and content must be considered together. Physicians are increasingly forced to choose among medical meetings and societies; content of meetings is increasingly scrutinized in terms of value for the dollar.

The changed medical economy, a greater emphasis on clinical productivity, de-emphasis of academic pursuits, attention to value for the dollar in terms of meeting content, falling behind the shift to a female-dominated specialty, an aging organization with a possible generation gap in the way medical societies are valued, and current membership requirements are all factors that may have played a role in the decline that the SAAOG has experienced. The SAAOG has been a premier obstetrics and gynecology society for >70 years. We have a long and proud tradition of excellence in research, education, promotion of quality, cooperation with similar organizations, recognition, and comradeship. This has all been accomplished through thoughtful and intelligent leadership, a lot of hard work, and a consistently outstanding and steadfast membership. As has been done in the past, the SAAOG will meet the current challenges head-on to ensure that we remain, in every measurable way, an outstanding association of obstetricians and gynecologists.