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Would anyone like to share their thoughts on the topic of laborists regarding the future of the field of OBGYN? I have searched the forum and couldnt find any topics related to this so i assume I'm not making a duplicate thread here.
Anyway, im still a 2nd year med student, so I havent yet done any OBGYN rotations to figure out if i have that true passion for the field, but i have been trying to learn as much as i can about it since there are many issues surrounding the field these days (malpractice, male vs female, etc). I was interested to see what current obgyns, residents, or other students thought about the laborist position in health care. The obvious "pro" is that it allows a more predictable work schedule and potentially less stressful lifestyle for the practicing OBGYN, which makes sense, since the recent trend in all fields of medicine have been towards lifestyle, and for OBGYN in particular, the rising number of female doctors who want to devote more time to family. The most prominent "con" is the lack of continuity of care, since the Laborist is simply working a shift and will deliver whoever comes into the hospital. This brings up a few questions for me:
Will other OBGYNs go for this, since many of them like to deliver their own patients to keep their patient relations strong and build their practices based on loyal patients and referals?
Regarding the lack of continuity of care, say you are an OBGYN in a group practice who takes call one day per week and one weekend per month. Presumably you are going to miss many of your own deliveries since the call is spread out amongst a group. But what is the difference between one of your partners delivering for your patient vs a laborist delivering? Presumably your patient doesnt have a pre-established relationship with either one, so if this is such a big problem for the laborist position in a hospital, why doesnt it affect the private group model also? (or does it?) And if theres really no difference, would more private groups want to hire a laborist to cover a few nights per week - sort of like a PA who can deliver babies?
Then there is the economic/litigious side of things which I admittedly know squat about. Ive seen figures that state that the actual delivery cost is about $1200, which would go to the laborist, with all of the other billing for care going to the primary obgyn, and perhaps possible malpractice sharing between them. But then if there is a malpractice case, who and what determines who gets the blame, especially if it is one of those cases in which there is really no one at fault?
Another potential idea...could hospitals in a university setting where there is high volume and low continuity of care to begin with, hire a laborist to cover one or two shifts a week, in order to decrease the work load of the residents? One of the big reasons no one wants to go into OBGYN anymore is the hours, and in residency you dont have the luxury of determining your own - maybe making the call schedules less malignant would draw more students into the field.
The articles I have read are pretty scant and most of them are outdated by several months to a year so I am not sure if all of my information is totally accurate, please correct me if I am wrong. Feel free to share your opinions on the subject or post any article links that you think are informative!
Anyway, im still a 2nd year med student, so I havent yet done any OBGYN rotations to figure out if i have that true passion for the field, but i have been trying to learn as much as i can about it since there are many issues surrounding the field these days (malpractice, male vs female, etc). I was interested to see what current obgyns, residents, or other students thought about the laborist position in health care. The obvious "pro" is that it allows a more predictable work schedule and potentially less stressful lifestyle for the practicing OBGYN, which makes sense, since the recent trend in all fields of medicine have been towards lifestyle, and for OBGYN in particular, the rising number of female doctors who want to devote more time to family. The most prominent "con" is the lack of continuity of care, since the Laborist is simply working a shift and will deliver whoever comes into the hospital. This brings up a few questions for me:
Will other OBGYNs go for this, since many of them like to deliver their own patients to keep their patient relations strong and build their practices based on loyal patients and referals?
Regarding the lack of continuity of care, say you are an OBGYN in a group practice who takes call one day per week and one weekend per month. Presumably you are going to miss many of your own deliveries since the call is spread out amongst a group. But what is the difference between one of your partners delivering for your patient vs a laborist delivering? Presumably your patient doesnt have a pre-established relationship with either one, so if this is such a big problem for the laborist position in a hospital, why doesnt it affect the private group model also? (or does it?) And if theres really no difference, would more private groups want to hire a laborist to cover a few nights per week - sort of like a PA who can deliver babies?
Then there is the economic/litigious side of things which I admittedly know squat about. Ive seen figures that state that the actual delivery cost is about $1200, which would go to the laborist, with all of the other billing for care going to the primary obgyn, and perhaps possible malpractice sharing between them. But then if there is a malpractice case, who and what determines who gets the blame, especially if it is one of those cases in which there is really no one at fault?
Another potential idea...could hospitals in a university setting where there is high volume and low continuity of care to begin with, hire a laborist to cover one or two shifts a week, in order to decrease the work load of the residents? One of the big reasons no one wants to go into OBGYN anymore is the hours, and in residency you dont have the luxury of determining your own - maybe making the call schedules less malignant would draw more students into the field.
The articles I have read are pretty scant and most of them are outdated by several months to a year so I am not sure if all of my information is totally accurate, please correct me if I am wrong. Feel free to share your opinions on the subject or post any article links that you think are informative!