Introduction: Roughly 50% of boys born in the United States (US) undergo newborn circumcision (NC), most often by obstetricians or pediatricians before hospital discharge. Anecdotally, pediatric urologists are facing increasing NC demand due to factors including declining clinician interest and staffing shortages. A few institutions have also recently reported experiences with advanced practice providers (APPs) performing NC. To illuminate recent practice patterns more fully, this study analyzed the proportion of NCs performed by different specialists over time. Methods: The IBM® MarketScan® Commercial Database was queried for NC private health insurance claims (Common Procedural Terminology 54150) between 2010 and 2020. Setting (inpatient/outpatient), US region, clinician specialty, and patient age (days) were determined for the full study time-period, and by study year. Simple linear regression assessed growth in proportion of NCs performed by pediatric urologists and APPs (nurse practitioner/physician assistant/midwife) over time. Results: In total, 952,772 boys underwent NC (Table 1). Most NCs were inpatient (59%) by obstetricians (46%) or pediatricians (33%); APPs performed 0.8%, and pediatric urologists performed 0.6%. The proportion of NCs performed by pediatric urologists increased from 0.3% in 2010 to 1.7% in 2020, and for APPs increased from 0.5% to 2.3%, p<0.0001 for both (Figure 1). Growth for both APPs and pediatric urologists predominantly occurred from 2016 to 2020. In 2020, pediatric urologists and APPs performed the highest percentage of NCs in the South (2.9% & 2.5% respectively), followed by the Northeast (2.5% & 1.4% respectively). Conclusions: The proportion of NCs performed by pediatric urologists and APPs increased significantly between 2010 and 2020, though both specialties still perform a minority of NCs. These data provide important baseline information for NC workforce planning, including evaluating collaborative care models where pediatric urologists train APPs to perform NCs. SOURCE OF Funding: None
