Working without OB coverage

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Backpack234

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Looking at credentialing with a new hospital. Major catch seems to be there's no OB coverage. I've never worked somewhere without this, so I've never been the one to catch babies in the ER. Not sure if this is a hard no for other docs or if I might be overthinking it. Does anyone else work somewhere without OB coverage and what's your experience? Is there anything major to know from a practice/liability standpoint?
 
Backpack234 said:
Looking at credentialing with a new hospital. Major catch seems to be there's no OB coverage. I've never worked somewhere without this, so I've never been the one to catch babies in the ER. Not sure if this is a hard no for other docs or if I might be overthinking it. Does anyone else work somewhere without OB coverage and what's your experience? Is there anything major to know from a practice/liability standpoint?
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How often do they do deliveries? My last hospital didn't have OB, and the one delivery I did was the first one at the hospital in 12 years.
 
I don't have it at my current shop. EMS knows well not to bring anything remotely OB/GYN in. If someone comes in, the hospital across the state line will take it without any trouble. I had a postpartum preeclampsia a couple of months ago and got them transferred there without any issues
 
I’m assuming it’s a smaller community hospital. If so, the community is pretty good about knowing there’s no OB. In my experience, you’re more likely to deliver somewhere with OB coverage than a place without.
 
RustedFox said:
I've never worked with OB coverage.
Never been a problem.
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Yes, but how many Floridian octogenarians are having babies? 🙂

I've worked in places with no OB in-house overnight, but never no OB at all. I imagine it would depend on the community, how close the nearest OB-staffed hospital is, etc. The liability would definitely scare me, though.
 
bky3c said:
Yes, but how many Floridian octogenarians are having babies? 🙂

I've worked in places with no OB in-house overnight, but never no OB at all. I imagine it would depend on the community, how close the nearest OB-staffed hospital is, etc. The liability would definitely scare me, though.
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Oh man. You’d be surprised how busy the ob practices in florida are.
 
Backpack234 said:
Oh man. You’d be surprised how busy the ob practices in florida are.
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Oh, I agree. I know Florida well. I realize the state isn't all 80+. It's just that Fox talks a lot about the elderly patients he sees, probably because they're more interesting.
 
bky3c said:
Oh, I agree. I know Florida well. I realize the state isn't all 80+. It's just that Fox talks a lot about the elderly patients he sees, probably because they're more interesting.
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Most community hospitals see more elderly people mainly based on the fact they’re much more likelier to need some kind of healthcare.
 
thegenius said:
Why? What is he supposed to do if there is a emergent delivery and he can't transport? Why is that automatic harm to the kid and thus a lawsuit?
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I've seen some of the most egregious suits imaginable among colleagues

I'm not saying you're wrong

I'm just saying opportunists are abound and you need to be in the right legal environment

My colleagues definitely weren't. I saw the suits. I saw their charting. I understood their decisions and would have done the same. Lawsuits anyways. All in progress dragging on for years and years, the outcome becoming increasingly irrelevant to the permanent anxiety it caused.

If op is in a good legal environment it's irrelevant I suppose
 
One of the hospitals I used to work at didn’t have OB. It was OK. Basically we just had an incredibly low threshold to transfer anything ob related.

Occasionally someone would catch a baby in the resus room but it was rare - like once a year.
 
I"ve worked at a few. Catch about one baby every 5 -10 years. But I also caught about 1 every 10 years in places that had L&D. All in 5 or 6 in 24 years. So far they've all been the sort the taxi driver could have delivered. Just like everything else you do the best you can. Am I as good as an OB or neonatologist? Not by a million miles. Am I better than the taxi driver? Probably. I transfer everything remotely OB. We could get someone to the nearest hospital with a labor deck in about 4 mins. One call to their labor deck where we had a prearranged transfer agreement. One call to 911 where the local EMS knew the drill. Favorite one ever was an exotic dancer who was 38 weeks pregnant and fell off the stage. Needed to be L&D obs for trauma.
 
Backpack234 said:
Looking at credentialing with a new hospital. Major catch seems to be there's no OB coverage. I've never worked somewhere without this, so I've never been the one to catch babies in the ER. Not sure if this is a hard no for other docs or if I might be overthinking it. Does anyone else work somewhere without OB coverage and what's your experience? Is there anything major to know from a practice/liability standpoint?
Click to expand...

For me, this was automatically a reason to reject a job. I wouldn't touch delivering babies on a regular basis with someone else's sterile gloves. Now rural critical access hospitals were a different story, as they didn't have that baseline traffic to begin with. But a facility that keeps OB in house and has an L&D unit and wants the EM doc to cover that L&D unit? No way.
 
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