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We used to have one physician in-house to cover both OR and L&D, with second call at home as backup. Now, both are in-house, with first call (comes in at 7pm) still taking most of the calls from both OR and L&D, but second (had been working all day) being able to handle one of those locations immediately, if first is engaged. When we first made that change, I brought up the idea of formally splitting the two, with one only covering the OR and the other L&D, but that was not popular.
Physician only. Hospital employed. 2 docs in house 24 hours, but the 2nd doc does all the sections during the day and at night kind of serves as a flex to the OR for traumas and covers peds code pager (never had it go off).. 2nd doc usually sleeps through the night in the hospital. It's the coverage the hospital wanted it seems. I think having the 2nd doc on for daytime sections is a huge plus, but overkill to have them overnight. I say this, but it is not uncommon to have 2 sections running at the same time in the middle of the night.
Our volume is way less than yours. Maybe like 3-4K/year at the most!
10K a year ?? Hospital needs to pony up for 1 in house MD dedicated OB and some form of backup as well. This should be a highly compensated shift in some way as you would not be "sleeping through the night". How is the day staffed ? At least 2 MD I would think unless board runner is putting in all the epidurals.