We believe an OBGYN hospitalist model makes it safer for women in labor and will positively impact maternal health in the U.S. The hospitalist concept and role is relatively new. With a better understanding we can help more people. You’ve asked us questions, and we’re pleased to share our knowledge and experience with you.
What is the difference between a laborist and OBGYN hospitalist?
The term “laborist” and “OBGYN hospitalist” have been used interchangeably, but as we see more OBGYN hospitalists in the field it’s important to understand the difference. A laborist is an older term, which was used when it was more common for physicians to solely tend to labor and deliver patients. Laborist has been replaced by OB hospitalists. An OBGYN hospitalist cares for labor and delivery as well as gynecological emergencies. Within this field, today 60% are OBGYN hospitalists and 40% are OB hospitalists. Some still like to be called Laborist to distinguish themselves from Internal Medicine or Family Medicine hospitalists.
An OBGYN hospitalist offers a wide range of support. Whether they are caring for women in labor whose practitioner is unable to respond immediately or performing surgery due to a ruptured ectopic pregnancy, an OBGYN hospitalist has the skills to support the hospital staff and any women’s health needs that may arise. The scope of service and rapid response they provide is of great value to a hospital.
With turnover of physicians the patient will receive varied quality of care. This is a negative experience for them. They lose the personalization and peace of mind by having a relationship with the patient. Also, I don’t want my patients to be cared for by someone they’ve never met.
The weeks or possibly years of a patient-doctor relationship, especially when it comes to pregnancy, is extremely valuable. For the mother, there is peace of mind and comfort in this. The goal of integrating an OBGYN hospitalist is to improve the quality of care and safety for maternal patients. Their role is to offer support and not replace the patient’s OBGYN.
If a patient’s doctor is not available immediately or if an emergency strikes, the OBGYN hospitalist model ensures there is always a specialist ready to respond quickly. Sometimes the minutes saved with a rapid intervention makes all the difference between a good and bad outcome for the mother and her baby.
Another familiar scenario is when a doctor has been working extended hours. For example, they’ve been called in to the hospital after working a full day in their private practice or they’ve been managing a patient in labor for over 36 hours. Both the patient and doctor are exhausted. An OBGYN hospitalist can help relieve the doctor and provide safer care for the mother.
A successful hospitalist model will set expectations. When hospital staff understand that the hospitalist is part of the team and patients understand the added support they will receive, processes, transfer of information, team culture and patient care is seamless.
Seeing the same doctor isn’t as common as it used to be. In the past, private patients would see only one doctor. Today, it’s normal for doctors to work in groups where the patient may see different doctors and be delivered by a doctor in the group they have never met.
Most importantly, patients appreciate the quick care and are impressed that a doctor is available to see them at 2:00 in the morning. And if a moment of urgency strikes, the patient, doctors and staff are grateful that an OBGYN hospitalist was there to support them.
When hiring an OBGYN hospitalist what experience and qualities should we look for?
A great OBGYN doesn’t always make a great hospitalist. When hiring an OBGYN hospitalist it comes down to their ability to collaborate in a team environment and their experience.
The most effective labor and delivery unit is a cohesive one. A hospitalist program will have OBGYN hospitalists work with midwives, Maternal-Fetal Medicine specialists, the emergency department, family physicians, OBGYN colleagues, an OBGYN or Family Medicine residency program, nurses, and patients. It’s important they have the ability to effectively and diplomatically communicate across departments and roles. Hospitalists with the mind-set to help not only the patient, but their colleagues, also goes a long way. Choosing a local physician, intrinsically motivated to improve their community could also be an asset.
Since OBGYN hospitalists must be ready to respond to any emergency, it’s important they have the experience to take a competent and calm lead. According to the Society of OBGYN Hospitalists 2016 Hospitalist Employment & Salary Survey, over 50% of respondents began work as a hospitalist 11 to 30 years after residency. An OBGYN hospitalist should be considered a specialist and their experience and skill set will determine that.
Through advocacy, education, and consulting, we can improve and advance the industry to provide the highest quality of care and safety for maternal health. The National OBGYN Hospitalist Consulting Group has a combined general OBGYN experience of more than 60 years and hospitalist experience of over 15 years. They are leaders in the industry, actively contributing to improvements and establishing standards towards the OBGYN hospitalist concept and the hospitalist role. If you are considering developing a new OBGYN hospitalist program, improving an existing one, or have any questions please contact us.
– Dr. Rob Olson