Mark Simon, MD, MMM, on the OB hospitalist care model

While the specialty has existed for decades, the integration of OB hospitalists into the modern maternity care model has become a critical driver of both safety and efficiency. Mark Simon, MD, MMM, Chief Medical Officer, Ob Hospitalist Group, Greenville, South Carolina, sat down with Contemporary OB/GYN to discuss how these site-based clinicians serve as a bridge between the emergency department and the traditional outpatient obstetric practice.

The primary responsibility of the OB hospitalist—whether a physician or a certified nurse-midwife—is to manage patients physically present in the hospital, providing a level of immediate acuity similar to that of an emergency room physician.

“That could mean emergent visits; for example, if a patient comes in complaining of an issue during their pregnancy, the OB hospitalist could be the one who sees them, much like an ER physician, but specifically for pregnant patients,” Simon explained. Beyond triage, hospitalists manage labor and antepartum care for patients who may not have a primary provider at that specific facility. “We could be the primary provider for those patients during their labor, especially if they do not have a physician who practices at that facility or a primary provider who performs deliveries,” Simon added.

How hospitalists collaborate with community providers

Rather than replacing the traditional obstetrician, the OB hospitalist functions as a collaborative adjunct to community-based practices. Simon noted that community physicians and midwives often leverage the hospitalist team to maintain continuity of care during off-hours or high-volume periods.

“They may turn over their patient’s care to the OB hospitalist for a certain time period—it could be a night, it could be a day, or whatever really makes sense and works for them,” Simon said. He emphasized that the goal is to “work collaboratively within that community to meet the community's needs,” ensuring that the presence of 24/7 on-site expertise supports, rather than disrupts, the existing physician-patient relationship.

Driving quality and rapid intervention

Because OB hospitalists are not distracted by running an outpatient business, they can dedicate 100% of their time to hospital-based quality improvement and protocol development. Simon highlighted the management of hypertensive crises as a primary example of where this 24/7 presence saves lives.

“There is a great deal of focus right now on managing patients who have elevated high blood pressure—hypertension in pregnancy—especially severe-level ranges,” Simon noted. “The goal is to have those patients assessed and treated very quickly because we know that if you do that, those patients can have better outcomes, both for them and for their newborn infant.”

By inserting the hospitalist into the acute care pathway, the facility ensures timely treatment while the primary obstetrician is in transit. As Simon concluded, this model allows the community provider to manage their outpatient workload “without disrupting the care they may be providing to other patients... and—as I like to say—keep them on a safe track for their pregnancy and delivery.”