The hospitalist business model has been adopted nationwide to help stem the tide of obstetrician/gynecologists who forgo delivering babies at hospitals—or providing emergency obstetric care—because of skyrocketing malpractice costs and a frustration with on-call schedules. Like the familiar HM model, a new class of OB-GYN has cropped up to work in medical centers.
Called laborists or OB hospitalists, this breed resembles hospital-based physicians: They work out of their respective institutions but don’t have private-practice patients. Hospitals like the arrangement because they have trained delivery staff in-house, and private-practice physicians don't mind giving up hospital calls because they can earn more cycling patients through their office.
The OB Hospitalist Group of Greenville, S.C., already has placed 60 OB hospitalists in six states, including Texas, California, and Florida. Group president Chris Swain, MD, hopes to place 100 by year's end, but only if he can find enough qualified candidates to manage both deliveries and OB emergencies.
"If you're going to be in a hospital 24 hours a day, you want to be able to handle all the emergencies that come in," Dr. Swain says. “You can't take time to look it up. You need to know it."
Dr. Swain's group pays for that knowledge. The average OB-GYN makes about $280,000 per year; Dr. Swain's OB hospitalists earn roughly $300,000 a year. In exchange for the higher salaries and defined work schedules, OB Hospitalist Group requires board certification, monitoring courses, and continued training. "We want our doctors to be the experts in emergency obstetrics care," Dr. Swain says. "We pay our doctors more; we expect more out of them."