hospitalist consultant

Why do Hospitals Ask for an OBGYN Hospitalist Consulting Visit?

Hospitals and their doctors request consultants for a variety of reasons, but OBGYN hospitalist related consultations are usually more specific.

Most requests originate from a hospital that is experiencing a series of bad outcomes in labor and delivery, which has led to malpractice events, or because local ob gyn doctors are stressed out and are looking for relief.

Sometimes these obgyn doctors learn of OBGYN hospitalist solutions while they are attending continuing medical education conferences.

The main reason either hospitals, a hospitalist company, an OB hospitalist group, or local obgyn physicians start an OBGYN hospitalist program is because it makes it safer for women in labor.

However, it also has the benefit of improving the work life balance for the private OBGYN’s as well as family practitioners and midwives who do deliveries.

Imagine being on call but yet able to sign out your responsibilities for a few hours in order to attend your child’s birthday party. This is just one example where obgyn hospitalists come into the scene.

Patients benefit because there is an experienced board-certified OBGYN physically present in the hospital to respond to an emergency and be available while their private practitioner is on the way into the hospital.

Patients are seen more rapidly for evaluation and studies show that the hospital experiences a reduced cesarean section rate.

In many hospitals, the OBGYN hospitalist also sees gynecologic emergencies in the main ED with the same rapid evaluation.

So although the reasons can vary for a doctor or hospital to request a consultation with a hospitalist about designing or enhancing a hospitalist program, it usually boils down to better patient safety and overall improvements for physicians and nurses and midwives.

If you have any questions or need to request Dr Olson for a consultation please contact Rob.

How are Ob.Gyn. Hospitalists Different from General Ob.Gyns.?

The only difference between ob.gyn. hospitalists and general ob.gyns. is work location, right? We all undergo the same residency training, pass the same boards to become board certified, and you have to be a general ob.gyn. to become a hospitalist after all. So, in one sense, there are no differences.

In addition to clinical skills, however, hospitalists do differ. As I outlined in my column “Ob.Gyn. Hospitalist Character Traits,” a hospitalist must be a seasoned professional and a team player, be willing to serve, inspire trust, be a good communicator, and be trained and incentivized to implement system-wide improvements.

Along with character traits, it is generally acknowledged that ob.gyn. hospitalists possess a specific set of core competencies. I began trying to formally define these during my first American College [now American Congress] of Obstetricians and Gynecologists annual clinical meeting (ACM) clinical seminar in 2010.

Dr. Bob Fagnant expanded on the initial ideas in a presentation at the second Ob.Gyn. Hospitalists’ special interest group meeting at the 2011 ACOG ACM in Washington, D.C. His presentation was well received, drew much interest from a large audience, and has initiated discussion that continues. The Society of Ob.Gyn. Hospitalists (SOGH) also has dedicated itself to defining the core competencies, but as this is such a new model of ob.gyn. practice, there is much yet to be debated, and discussion should be expected and encouraged.

As stated above, the ideal hospitalist should be a seasoned professional. ObGynHospitalist.com employment surveys from the past 2 years showed that only 7% of ob.gyn. hospitalists started hospitalist work within 5 years of completing their residency. I think all of us agree that it is very difficult for a new residency graduate to acquire the skills and experience to step in and perform as a hospitalist. Not to say that it’s impossible, just very difficult in light of most residency volumes combined with residency hour restrictions.

One idea that I have heard several academic centers beginning to discuss is that of a fellowship for ob.gyn. hospitalists. Advanced training in a fellowship could provide more experience for new graduates, but it would be especially helpful for experienced, board-certified ob.gyn. hospitalists to hone not only their clinical skills, but also learn the administrative, simulation teaching, team leadership, and information management skills to take existing hospitalist programs from good to great and to start new programs at the highest skill level.

This idea is in its infancy and faces obstacles. Most experienced ob.gyns. may be unwilling to leave their current private practice positions and return to the lifestyle, hours, and, especially, the payoff of a fellow. However, there may be creative solutions similar to executive MBA programs, such as online learning, reviewing curricula designed by the academic center, and periodically traveling to the center for weekends or more prolonged times for the hands-on clinical training and experience portion over a year or two. Introduction of a new additional program needs to be handled carefully because such a program for hospitalists cannot reduce or take away from the clinical training experience of current residents and maternal-fetal medicine fellows.

Like the development of the core competencies necessary for ob.gyn. hospitalists, it will be fascinating to watch the development of academic programs for ob.gyn. hospitalist fellows. It will be exciting to see the first graduates and even more exciting to see the first board-certified ob.gyn. hospitalist in a new subspecialty. Will an old hospitalist like me get grandfathered in if I can pass the new (yet to be determined) American Board of Obstetricians and Gynecologists’ board certification for ob.gyn. hospitalists?

We are lucky to have the SOGH in a position to hear discussion and debate and to advocate for commonly agreed-upon positions. There are so many questions to answer to define the difference between general ob.gyns. and hospitalist ob.gyns., but we are on the cusp of not an evolution in care for women in the hospital, but a revolution. The future is unknown, but the direction from the known is extremely positive. Not only is patient care becoming safer, but the system is becoming safer and more cost efficient while at the same time improving the lifestyle of the general ob.gyn. practitioner. This last sentence will be backed up by data and experience in the near future, I predict.

Originally posted JANUARY 18, 2013 on ehospitalistnews.com