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    New life for old obstetricians

     

    With change comes resistance—not just from other ob/gyns and family physicians who may be concerned that hospitalists will poach their patients and take their income—but also from nurses, hospital administrators, and patients who may initially regard this new model with caution. The advantages, however, quickly become apparent: Increased maternal and fetal safety; improved quality of life for both ob/gyn hospitalists and private ob/gyns; immediate back-up for family doctors, midwives, and nurses; and system-wide improvement for labor and delivery.

    The most recent studies show that full-time ob hospitalist programs are associated with substantial 15% reduction in cesarean delivery rates1 and a decline in induction of labor and preterm deliveries.2 Also the newly established Society of OB/GYN Hospitalists and its committees are working to increase the model’s visibility and acceptance and to prove its legitimacy as the future of ob/gyn care in the United States.

    While still in its infancy, and with at least 2000 ob/gyn hospitalists3 in more than 300 programs across the United States, the hospitalist model offers a better quality of life for private ob providers and hospitalists. Importantly, it allows the wealth of knowledge and clinical experience from an older group of physicians to be leveraged rather than lost through early retirement or abandoning ob. It offers boomer-aged ob/gyns a chance at a second, more balanced career that many are racing to take.

    References

    1. Iriye B. et al. Implementation of a full-time laborist program is associated with a substantial reduction in cesarean section rate. Am J Obstet Gynecol. 2013 Sep;209(3):251.e1-6.

    2. Srinivas S et al. Does the laborist model improve obstetric outcomes? SMFM 2013; Abstract 79.

    3. Funk C, Anderson BL, Schulkin J, et al. Survey of obstetric and gynecologic hospitalists and laborists. Am J Obstet Gynecol 2010;203:177.e1-4.

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