You Asked. We’ve Answered Part 2: Demystifying the OBGYN Hospitalist Model and Hospitalist Role

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Without education and understanding, market changing innovations and alternative methods can be slow to integrate. The OBGYN hospitalist model is a relatively new concept that is quickly growing across the country as hospitals see the benefits of improved safety and quality of care for women. We want to demystify the OBGYN hospitalist model and role by answering your questions in an effort to support these benefits and the field.

 

Doesn’t a hospitalist model mainly benefit the hospital and insurance companies while patients, doctors and staff are secondary?
The purpose of an OBGYN hospitalist program is to improve the quality of care and safety for women with the mother and child as the primary focus with about one half of programs incorporating gynecology.  An OBGYN hospitalist supports the welfare of patients through:

  • Specialized skills and experience with high-risk obstetric and gynecological situations
  • Immediate response and timely intervention
  • Supporting obstetric providers and hospital staff, such as, Perinatologists (MFMs), midwives, Family Practitioners, the emergency department, OBGYN colleagues, and OBGYN or Family Medicine residents

 

A hospitalist program can benefit a hospital in many other ways:

  • Fewer bad outcomes occur with specialized maternal care and 24/7 coverage, which may lower the occurrence of malpractice claims
  • Access to an OBGYN hospitalist may lighten the pressure on staff that are less experienced with obstetrical and gynecological emergencies, which has a positive impact on morale, confidence, and subsequently less turnover
  • Increased revenue for departments outside of obstetrics, such as the NICU

These reasons make the OBGYN Hospitalist model a “win-win solution”. Patients are receiving high-quality and safe care around the clock, hospitals provide added value services and staff are well supported.

There is no benefit to insurance companies as they reimburse at the same rate.

 

Shift work devalues your worth as an OBGYN physician.
OBGYN hospitalists are exposed to obstetrical and gynecological emergencies on a more regular occurrence than in private practice. This experience quickly enhances their skills in managing emergent and high-risk, low volume situations, adding further to their competency and value.  

As a hospitalist, I need to establish patient rapport quickly; this is amplified in emergent situations.  I enjoy rounding on patients and reviewing the events that occurred. I don’t need it to know I did my job well, but I appreciate and enjoy the “Thanks Doc” and grateful handshake or hug from the patient, spouse and family for helping them through a critical situation. I was wrong when I thought in my work as a hospitalist I would not have this kind of satisfaction that I experienced when caring for a patient for a long time and through several life events as I did in private practice.  

Compensation is slightly lower than the average private OBGYN physician; however, the hours a hospitalist works is significantly less. Shift work mitigates stress levels and allows for work-life balance. Overall, establishing personal well-being is invaluable and sustainable.

The hospitalist role is relatively new. Demand is increasing, but supply has not. Therefore, there will likely be upward pressure for increased hospitalist compensation.

 

OBGYN hospitalist programs are very expensive. How can we justify the investment?
Hospitals invest in a hospitalist program to improve the quality of care and safety. The expense may seem steep. When you review the benefits and revenue generating opportunities, a hospitalist program is not only effective, but also a fiscally justifiable solution.

From a savings perspective, safer care results in fewer bad outcomes and lower malpractice claims. According to the 2017 Medscape OBGYN Malpractice Report, the monetary reward that plaintiffs received was substantial: 33% were up to $500,000 and 18% were from $500,000 to $1 million. Lowering malpractice claims is a potential huge savings. The data from OBGYN hospitalist programs is accumulating and more specific information will be available soon.

Another area of potential savings is the reduction in funds paid to private OBGYNs to take emergency calls. Having an OBGYN hospitalist on duty limits these occurrences.

The revenue generating opportunities can also help subsidize a hospitalist program. It’s common for hospitals to increase triage/OB ED visits, transfer fewer high-risk patients, attract perinatology programs and increase NICU volume.

There are costs to improving the safety and quality of care for patients, but I believe the benefits far outweigh these. Most important, what is the value of making a difference in an emergent situation and possibly saving a life? Absolutely invaluable.

 

 

– Dr. Brendan Carroll

 

Connect with the National OBGYN Hospitalist Consulting Group on Twitter @ObGHospitalist or LinkedIn

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