{ "source": "Cooked Index — occupational AI risk register", "page": "https://cookedindex.com/jobs/obstetricians-and-gynecologists/", "methodology": "https://cookedindex.com/methodology", "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.", "scored_at": "2026-08-11", "model": "claude-opus-5", "occupation": { "title": "Obstetricians and Gynecologists", "soc_code": "29-1218", "category": "Healthcare", "us_employment": 21260, "median_annual_wage": 292910 }, "verdict": "SAFE", "risk_resistance": 91, "contested": false, "near_boundary": false, "dimensions": { "task_resistance": 16, "embodiment": 20, "liability_shield": 20, "trust_premium": 17, "judgment_accountability": 18 }, "reasoning": { "task_resistance": "Reading a fetal heart tracing and deciding to move to the OR, then getting the head out through a shoulder dystocia with the McRoberts and Woods maneuvers, are not documentable-and-delegated tasks; the 16 rather than 19 reflects that a real share of an OB/GYN's week — well-woman counseling, Pap and HPV result triage, contraceptive management, prenatal visit templates — is protocol-driven and already partly absorbed by nurse practitioners, midwives and algorithmic screening.", "embodiment": "There is no version of a cesarean, a manual placenta extraction, a cerclage, a colposcopy-directed biopsy, or a bimanual uterine massage for atony that happens through a screen, and the environment is uncontrolled by definition: labor decompensates on its own schedule, the patient is bleeding, and you are the person with your hands inside a body cavity — that is the top of the band.", "liability_shield": "State medical licensure plus DEA registration plus hospital privileges and board certification all attach to one named individual, and obstetrics carries among the highest malpractice premiums and longest tail liability in medicine because a birth injury claim can be filed until the child reaches majority — the physician who signed the delivery note is the defendant, not the software that flagged the tracing.", "trust_premium": "Patients pick an OB/GYN and stay for decades of Paps, contraception, infertility work-up, and then choose who is in the room at the birth of their child — that continuity is the practice's economic base; the 17 rather than 20 acknowledges call-pool reality, where the person delivering you at 3 a.m. is often whoever is on the schedule.", "judgment_accountability": "Deciding whether to induce at 39 weeks, when to abandon a trial of labor after cesarean, whether a previable pregnancy meets the state's maternal-life exception, or how to counsel a patient with an abnormal NIPT result are calls made under time pressure with incomplete data and two patients' interests to weigh — the 18 rather than 20 reflects genuine guardrails from ACOG practice bulletins and institutional protocols." }, "rationale": "The core of this job is physically inseparable from the patient: pelvic exams, cesarean sections, hysterectomies, laparoscopy, forceps and vacuum deliveries, and managing a hemorrhage at 3 a.m. AI is already useful for documentation, ultrasound and cytology screening, risk stratification, and coding, which trims clerical load but not clinical work. State licensure plus malpractice exposure — obstetrics is among the most litigated specialties — makes a named human physician legally and personally accountable for every delivery and operative decision.", "outlook": "Demand stays ahead of supply through the 2030s amid maternity-care deserts and retirements; AI absorbs documentation and screening reads, which mostly buys back clinic time rather than cutting positions.", "what_would_raise_it": { "levers": [ { "dimension": "trust_premium", "change": "Continued shift of low-risk births to midwife-led and freestanding birth-center care raises the OB's remaining case mix to high-acuity, and patients choosing hospital OB care are specifically buying named-physician continuity (e.g., laborist vs. private-practice 'my doctor delivers me' models marketed by practices, plus doula/patient advocacy pressure for a known attending). If payers begin covering continuity-of-provider arrangements explicitly, the willingness to pay for a specific human becomes contractual rather than preferential.", "plausibility": "plausible", "would_add": 2 }, { "dimension": "task_resistance", "change": "Task-mix shift: ambient documentation (Nuance DAX, Abridge), AI fetal-biometry and cytology triage, and autocoding absorb the clerical and screening tier, leaving operative management, shoulder dystocia and hemorrhage response, and ambiguous fetal-heart-tracing calls. The residual day is almost entirely the judgment tier.", "plausibility": "already happening", "would_add": 2 }, { "dimension": "judgment_accountability", "change": "If ACOG/state perinatal quality collaboratives formalize a named-attending sign-off for AI-flagged fetal monitoring interpretation and for cesarean indication (mirroring existing NTSV cesarean-rate accountability reporting), the ambiguity calls become explicitly attributed rather than diffused across a care team.", "plausibility": "plausible", "would_add": 2 } ], "ceiling_note": "embodiment and liability_shield are already at 20; the composite is within a few points of the maximum, so realistic movement is marginal. The meaningful risk to this occupation is scope reallocation to midwives and CNMs and rural unit closures cutting headcount, not AI substitution of the physician's task set." }, "adjudication": null, "employment_history": { "points": [ { "y": 2019, "emp": 18620, "wage": 239200 }, { "y": 2020, "emp": 18900, "wage": 239200 }, { "y": 2021, "emp": 21570, "wage": 239200 }, { "y": 2022, "emp": 21450, "wage": 239200 }, { "y": 2023, "emp": 19820, "wage": 239200 }, { "y": 2024, "emp": 19900, "wage": 239200 }, { "y": 2025, "emp": 21260, "wage": 292910 } ], "from": 2019, "to": 2025, "change_pct": 14.2, "comparable_from": 2019, "spans_soc_revision": false }, "pivots": [], "license": "https://cookedindex.com/terms" }