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The Maternal-Fetal Medicine (MFM) market is now heavily hospital- and health system-based, with private practice becoming increasingly rare as most groups are acquired by larger systems.

Key trends driving this shift:

• Workforce shortage: There are very few MFMs nationally, pushing hospitals to offer stable, employed roles
• Practice preference: Many MFMs prefer consultative high-risk pregnancy care rather than deliveries or practice ownership
• Private practice decline: Independent groups are being acquired by hospitals, with limited new private practices forming
• Employment stability: Hospital roles offer predictable salary, benefits, and job security
• Lower administrative burden: Physicians avoid billing, staffing, and business management responsibilities
• System-based care models: Telemedicine and centralized ultrasound review support hospital consolidation and efficiency

Maternal Fetal Medicine Physician's compensation remains very competitive due to a national shortage of subspecialists. Many candidates are now expecting $500,000+ in desirable locations, with even higher pay in less desirable or underserved areas.

Beyond salary, physicians are prioritizing lifestyle and flexibility, including remote or hybrid roles and positions focused exclusively on ultrasound reads and consultative care. There is also a strong preference to avoid OB deliveries and OB call responsibilities.

Health systems are responding by offering higher compensation, more flexible work models, and more focused clinical roles to attract and retain MFMs.

Reproductive Endocrinology and Infertility (REI) remains a highly specialized, in-demand subspecialty within the OB/GYN field, with growing need across the country.

Demand continues to rise as more women are having children later in life, including pregnancies into the late 30s and 40s. This shift has increased the need for fertility evaluation and treatment. In addition, higher rates of obesity and other chronic health conditions are contributing to more complex fertility challenges.

At the same time, the number of newly trained REI physicians remains limited due to a highly competitive fellowship pipeline. This has created ongoing shortages in many areas, and in some cases patients travel significant distances to access care.

REI compensation typically ranges from $300,000-$600,000+, depending on location, experience, and practice type. Many roles also include production bonuses in addition to a guaranteed base salary.

Bonus potential varies widely, from about $10,000 to $150,000+, depending on the institution and volume.

When reviewing offers, it’s important to ask how production is measured and what a typical first-year bonus looks like in practice.

REI physicians most commonly work in private equity-backed practices, private practices, or hospital/health system-affiliated roles. Private equity involvement is more prominent in REI than in many other OB/GYN subspecialties.

Private equity-backed groups often provide stable salaries, strong benefits, and robust practice management support, allowing physicians to focus primarily on patient care. However, some physicians express concerns about reduced autonomy and a more production-driven environment, which can contribute to burnout in certain settings.

Private practice offers greater clinical autonomy and the ability to build long-term patient relationships, but compensation is typically more variable and can be lower depending on location and practice structure.