OB Hospitalist
OB hospitalists work in shifts, covering the maternity ward as well as dealing with
emergency obstetric cases.  Since they are employed by the hospital, their malpractice
premiums are covered, and there are no back-office expenses like those of an outside
practice. Hospitalists can also be a plus for a new mother, since their limited hours keep
them fresher and less prone to errors, and their job description focuses on attending to
her during labor. They are physicians who generally have experience working in a
private practice. They come from all over to join the hospital in maintaining standard of
care and helping facilitate faster more efficient care for the patients who are staying in
the hospital requiring care their physician cannot give them immediately (Hobson,
2005).

The idea began in 2003, when Louis Weinstein proposed the idea to the American
Journal of Obstetrics and Gynecology. Weinstein thought hospitalists could help solve
one of the biggest problems in the profession. The grueling daily schedules. A doctor  
may end up driving across town several times a day to see patients and they often have
to get up in the middle of the night to deliver a baby. Weinstein also states “ In labor and
delivery things can go wrong fast and if you are not responsive in minutes, a baby can
be damaged or die and the mom could die” (Hobson, 2005).

In the labor and delivery unit at Scottsdale Healthcare Shea there are 4 hospitalist that
cover the unit 24 hours a day 7 days a week. They are used as an excellent resource
when a nurse needs someone to help critically think about what may be going on with
the patient. In triage they are used to find fetal heart tones via ultrasound when the nurse
is having trouble finding them. This is excellent patient care because it they find them it
brings relief to the patient saving time to do a formal ultrasound that may take hours. If
the outcome is bad, it is comforting to have a physician there by the patient’s side
giving them the bad news instead of having them wait until the primary doctor gets there.
They are there to expedite the labor process when the physician is unable to break the
patients water due to scheduling conflict. They are used in emergency situations when
the patient requires an urgent cesarean section. The hospitalist can either be the
primary physician to make the call or they can assist the primary physician when a first
assist would take to long to get to the hospital. This saves time that is critical in an
urgent situation.

On occasion they have had to deliver babies that decided to come to quickly. If the
hospitalist were not there the nurse would have had to deliver the baby. Before the
hospitalists came that was what happened, it is so relieving to have a skilled
professional right there when you need them. There was an instance when a patient
came in to the unit in labor only to find out she was fully dilated and one of the babies feet
was coming out first, she did not know she was breech. There was no doctor on the floor
and delivery was imminent. The hospitalist came and delivered the baby without
complication. I believe if he were not there the outcome would have been much different
because it was difficult for an experienced doctor to get that baby out. The nurses would
have been in a very difficult situation.

Financially hospitalists have saved lives and the hospital from potential lawsuits. They
are on the floor giving better quality care when a primary physician is unable to be there
to break a patients water or put in a uterine pressure catheter leading to patient
satisfaction with less time during the labor process and less time away from the family
unit at home. They expedite the labor process. The patients get tests sooner, and the
satisfaction of our unit is 99%.

References
Hobson, K. (2005, November 27). Divison of Labor. U.s. News. Retrieved
08 10, 2008, from www.usnews.com Web site:
http://healthe.usnews.com/usnews/health/articles/051205/5labor.htm

Submitted by:
OB Hospitalist
Lynn Stock
Grand Canyon University
8/10/08
Obstetrics