By Rob Olson, MD
In the “olden days,” ob/gyns would drop the ob part of their practice (ie, delivering babies), as soon as possible because of ob’s numerous challenges, among them long and erratic hours, enormous and expensive malpractice risk, and the fact that the unpredictability of labor and delivery interferes with office hours, scheduled elective surgeries, and any semblance of normal family life. Baby boomer ob/gyns who did not want to stop obstetrics had few options except to assume the high risk, terrible hours, high insurance costs, and stressful lifestyle, or stop doing obstetrics entirely and change to a gynecology practice only. The latter was not a good option for doctors who, like me, love obstetrics.
Today, however, there is another option that gives old obs a new life and second career. A new model of ob care offers a chance for today’s older physicians who are highly experienced and motivated to alter their career paths and avoid “forced” retirement from ob by becoming ob/gyn hospitalists.
Sometimes referred to as “laborists,” ob/gyn hospitalists are experienced, board certified ob/gyns who are physically present in a hospital to respond to all ob and gyn emergencies. They commonly triage all incoming ob patients and are responsible for all unassigned laboring patients. Private ob/gyns who cannot be physically present in the hospital can sign out their patients to the ob hospitalist to monitor or treat as required. OB hospitalists assist with surgeries, do patient rounds, teach, consult, and are immediately available when needed for emergencies.
The medical reasons for this model are straightforward: Immediate treatment or intervention leads to increased patient safety, which in turn can reduce bad outcomes, lessen malpractice situations, shorten hospital stays, and increase patient satisfaction. Hospitalists can also look after high-risk patients as “perinatologist extenders,” helping to augment increasingly scarce maternal-fetal medicine physicians who would traditionally perform this function.
The personal implications for the ob hospitalist are just as exciting. I love delivering babies as a hospitalist, working defined shifts without the responsibility of an office, and honing my clinical ob skills to assist medical personnel and improve the safety of hospitalized women.