OB-GYN Society Takes Step Toward HM Model


The American College of Obstetricians and Gynecologists (ACOG) has given a preliminary imprimatur to the HM model, whose practitioners are known in maternity circles as laborists.

ACOG’s Committee on Patient Safety and Quality released an internally published opinion this month describing the structure as “one potential solution to the achieving increased professional and patient satisfaction.” The committee, however, stopped short of formally approving the laborist movement, its chair says.

“ACOG is not officially endorsing this as a standard and a must,” says Patrice Weiss, MD, chair of the Carilion Clinic’s OB-GYN department in Roanoke, Va. “This is an option for communities or hospitals in which there may be a manpower issue with obstetricians.”

The college’s qualified blessing sees advantages in the “obstetric-gynecologic hospitalist,” including the relieved pressure of not running a private practice, more predictable schedules, competitive compensation, paid benefits, and guaranteed time off. Internal-medicine hospitalist programs routinely tout those same benefits when advertising for openings. The committee opinion adds that the laborist model also delivers benefits to a hospital, including enhanced patient safety, increased levels of nursing satisfaction, and, potentially, improved outcomes.

Dr. Weiss cautions that while the laborist approach is “gaining popularity and momentum,” institutions must safeguard against potential issues, such as arguments with PCPs over delivery fees and potential complications on handoffs. While internal-medicine HM groups have long dealt with potential frictions between PCPs and hospitalists, the conflicts are still developing in the laborist model.

“For such a program to be implemented, clear, concise communication between the providers, patients, and hospitals is key,” Dr. Weiss says. “Up-front communication will prevent surprises.”

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