Topic # 12: Starting A New OB Hospitalist Program

The most salient point you said was that the job should not be offered to
new graduates as they will loose their GYN skills and that they will not be
able to go general OBGYN work as our work is limited by the number of calls and the type of patient we see. I see this job as a gradual easing into retirement. However, this is no time to put down your guard as disasters can happen at any moment. I'd like to see more courses on OB GYN emergencies and simulations run at least on an annual or biennial schedule. (Maybe like the one ran by Tom Benedetti at the ACOG)
Alex

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I am an Ob/Gyn in solo practice with a midwife who works part-time, daytime hours. In my city there are 5,000+ deliveries.  The hospital has a group of Ob/Gyns, midwives and midlevels who perform approximately 1,300 of those deliveries.  They always have one physician and one extender (CNM or PA) in the hospital.  There are also approximately 21 other Ob/Gyns.  Of those 21 other Ob/Gyns there are two "big groups", both with four Ob/Gyns.  There is one group of three Ob/Gyns. The remaining 10 Obs are in solo practice or have two in a group.  Many of these cover for each other either on weekends or both during the week and weekends.  Many of us take call every other to every third day and also the three days during the weekend (Friday 12p to Monday 8am).  Needless to say it is very tiring.  We have discussed a hospitalist program to help with quality of life and patient safety but the physicians have been hesitant because of financial reasons and loss of control of their patients.  Our payor mix is approximately 60% Medicaid.  Any thoughts from you or other members of the discussion group are greatly appreciated.

Respectfully,
David Schutzer, MD