Debating the laborist model of care
Boon to obstetric outcomes or bellwether of lifestyle choice?
In this first installment of Contemporary OB/GYN’s Point/Counterpoint department, two physicians discuss the advantages and disadvantages of the laborist (or “hospitalist”) model of care. What are the pros and cons for ob/gyns and their patients?
PRO by Karenmarie K. Meyer, MD, FCOG
It’s 2 pm, you had 2 deliveries after midnight last night, and you are still in scrubs. You’ve been in the office since 10 am. You are 45 minutes behind and have 15 patients left to see. A call comes from the hospital labor and delivery department informing you that a term VBAC patient just arrived in labor and you need to be present. You will have to cancel the rest of your office patients and deal with all that goes along with doing so. You have to call home to say that once again you won’t be coming home for dinner. It’s a scenario familiar to most ob/gyns.
Now consider this scenario, which you would experience as an ob/gyn practicing at one of the more than 185 hospitals that have ob/gyn hospitalists available. You can sign out of your hospital practice to a board-certified, experienced, emergency-ready obstetrician who can admit and manage your patient for you. You can finish your office appointments, go home for a family meal, take a needed nap, and then go to the hospital and take back management of your patient’s labor, more alert and more focused than you otherwise might have been.
Ob/gyn hospitalists (also known as “laborists”) are available 24/7 to support and assist private physicians, nursing staff, midlevel caregivers, and patients. We are immediately present and respond to obstetric and gynecologic emergencies. We can take on unassigned patients, monitor tracing strips, perform triage, and quickly facilitate the transfer of patients to higher-level units when needed.