REI scope of practice

[Cholinergic]

Is it possible for a reproductive endocrinologist/fertility specialist to manage her/his patients if they get pregnant? Or do they usually send these patients back to a generalist or high risk OB? One of the challenging things I find about OB/Gyn is I love the entire scope of the field but find that in choosing a specialty, you will lose something.

---

Members don't see this ad.

 

[drsungoddess]

I am not sure about the rules, but talking with docs, they say that REi transfers all pts over right away and that they are not even doing too many surgeries any more. All about the IVF so they can make the big bucks.

Sad, I like the field too, but would like to do more than just IVF.

 

[DomoDomo]

I am not sure about the rules, but talking with docs, they say that REi transfers all pts over right away and that they are not even doing too many surgeries any more. All about the IVF so they can make the big bucks.

Sad, I like the field too, but would like to do more than just IVF.

Seems like there are not a lot of REI jobs/work out there these days, is it possible to work as an REI and a general obgyn after the REI fellowship? Are there rules preventing this?

 

[anonperson]

Seems like there are not a lot of REI jobs/work out there these days, is it possible to work as an REI and a general obgyn after the REI fellowship? Are there rules preventing this?

Theoretically it is possible. I know of MFMs who act as generalists in private practice (doing gyn surgery etc).

It's not common because you make more as a subspecialist.

In addition, most REI patients come as referrals. Getting them successfully pregnant and further managing them to delivery probably wouldn't go over too well with referring docs as you're taking away a source of revenue.

I have heard of some academic REIs who sometimes cover the resident OB service. Not very common though.

 

[Geekchick921]

I'm under the impression REI docs send their patients back to their general OB by the end of their first trimester. That's based on the experiences of a number of online friends that have needed their expertise, though, not any personal experience on either side.

 

[gynogrl]

It's absolutely possible (you're board certified in OB/GYN and REI), but like anon person said, it's uncommon because of the pay structure. If you spend three years in fellowship after residency to get to do IVF and other REI procedures, it's not financially savvy to do the same things in your practice that you could've done without a fellowship.

That is the issue with specializing, and I'm facing the same dilemma. If you focus on one area, you miss out on others. I'm sure that's the same issue with every field, but it does seem more extreme in this field. Good luck making a decision.

 

[Global Disrobal]

In my experience (at an academic MFM practice), we are fed by both our institution's REI practice as well as the private ones in the region. As stated above, the majority of patients who are otherwise low risk (e.g. singleton) are referred back to the primary OB for further care. The remaining high risk ones are sent to us for 1) primary management or 2) recommendations and primary care by their OB.

I do agree with the above post that it is unlikely to see an REI sub-specialist manage a pregnancy as 1) it is no longer within the focus of their practice, 2) liability considerations, and 3) out of consideration for the referring providers (not to take food out of their mouths)