OB/GYN Hospitalists: Emerging Trend or Sustainable？

　　The role has both advantages and challenges.

　　Obstetrician/gynecologist (OB/GYN) hospitalists are physicians who assume care of laboring women on a shift basis and manage obstetric triage and in-hospital obstetric emergencies. The driving need for this new role (sometimes referred to as laborists) centers on the overlapping goals of patient safety, improved efficiency, and decreased clinician fatigue. OB/GYN hospitalists can be present immediately to manage labor and can work jointly with private obstetricians while spearheading new policies concerning labor and delivery, becoming experts at certain procedures, and supervising residents. Currently, 177 OB/GYN hospitalist programs exist in the U.S., and a new national association, the Society of OB/GYN Hospitalists, has been established.

　　For patients, benefits of OB/GYN hospitalist programs include shorter wait times for clinical decisions, improved communication between nursing and private practitioners about plan of care, and immediate availability of a physician for deliveries, postpartum complications, and ultrasound scans. Nurses also reap advantages: OB/GYN hospitalists can evaluate laboring women immediately (thereby reducing the amount of time devoted to contacting physicians offsite), contribute clinical expertise, and handle unanticipated emergencies. For hospitals, the presence of an OB/GYN hospitalist program has the potential to lower malpractice premiums, encourage recruitment of physicians, and provide more control over patient care practices. Challenges faced by hospitals include the need to subsidize a major portion of the program up front and the need to reconsider how residents can accumulate sufficient cases (including gynecology cases) as they prepare for board certification.

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