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old on to your obstetrician if you live in Las Vegas, Orlando, Fla., Miami, Los Angeles, or Riverside, Calif. It might be hard to find another one.

These five metro areas are the most likely to experience a major shortage of OB-GYNs in the coming years, according to researchers with Doximity, a social network for U.S.-based clinicians.

Nearly half of all U.S. counties already lack a practicing OB-GYN. The American Congress of Obstetricians and Gynecologists projects a shortage of up to 8,800 OB-GYNs by 2020. And Pew Trusts predicts the nation could be 22,000 practitioners short in the decades that follow.

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“We’ve known this shortage is coming,” said Dr. Valerie Jones, a former OB-GYN who retired from practice in Maryland last year. “But it’s worse than we actually thought.”

The Doximity report, which looked at data from more than 30,000 OB-GYNs practicing in the nation’s 50 largest metro regions, found the cities with the highest risk of a shortage had a confluence of doctors retiring early and few younger doctors replacing them.

“From maternity care to screening for cancer and critical primary and preventive care, OB-GYN specialists are at the front line of women’s health care,” Dr. Nate Gross, co-founder of Doximity, said in a statement. “Understanding potential OB-GYN shortages is a key starting point in addressing the problem, and our data shows that we have a growing risk in cities across the country.”

Consider Las Vegas, the metro region with the highest risk of a shortage. Nearly 40 percent of OB-GYNs are age 55 or older — and only 10 percent are younger than 40.

Health experts attribute the pending shortage to a variety of issues including fatigue from working unpredictable late-night hours and fears of being sued for medical malpractice. The specialty has one of the highest burnout rates among physicians; many OB-GYNs retire early in their 50s, Doximity found.

And the career is especially stressful in some of the cities at the highest risk of shortages. Obstetricians in Riverside, Calif., for instance, deliver more than twice as many babies each year on average than their peers across the country, according to the report.

Jones believes Doximity’s findings are likely conservative estimates, considering the OB-GYN specialty is mostly comprised of female doctors, who are more likely to work reduced hours and retire earlier than their male colleagues. Likewise, she suspects rural parts of the country face an even greater shortage than in cities.

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So, how should the problem be tackled?

Chris Whaley, author of the Doximity study and assistant professor at the University of California-Berkeley’s School of Public Health, said potential solutions include enticing medical students into the specialty with financial incentives and expanding the use of telemedicine to treat patients where appropriate.

In the short term, Jones said training more nurses and midwives to do some of the work could help prevent doctors from being overtaxed. Ultimately, she thinks medical schools will need to increase residency slots to prevent the shortage from getting worse.

“The shortage is already being felt now where patients who have insurance can’t get in for appointments,” Jones said. “As more retire early, it’ll make the issue worse for practicing OB-GYNs.”

Doximity Report: OB-GYN Workload and Potential Shortages

This story has been updated to more accurately reflect the typical retirement age of OB-GYNS

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