Rob Olson, MD

It’s bittersweet that this will be my last column, but I appreciate the opportunity that this news organization has given to me, and it’s been an honor to share my thoughts about the new ob.gyn. hospitalist model, how it is changing our profession, and the future that lies ahead.

This is an exciting time to be in this rapidly evolving field because this is a new way of delivering health care to women by utilizing board-certified ob.gyns. who are physically present in the hospital. Their presence has led to proven increases in patient safety, a demonstrable reduction in bad outcomes, as well as decreased malpractice costs. Additionally, programs not only lead to increased lifestyle satisfaction for hospitalists, but contribute to reducing private ob.gyns.’ stress and conflict of needing to be in the office and the labor and delivery department.

Although hospital administrators have to pay the considerable gap between the costs of these programs and the amount of billing provided to the hospital by the work the physician hospitalists perform, administrators also are very satisfied. This can be seen by the veritable explosion of new hospitalist programs across the United States. When I began my career as a hospitalist in 2007, I could only find 15 programs, and now there are 200 nationally.

If I speculate and try to imagine 3-5 years in the future, I think there will be ob.gyn. hospitalists in at least 75% of all hospitals delivering 2,000 or more babies per year. That means there will be at least 102 programs employing approximately 612 (6 × 102) hospitalists.

For those of you considering this opportunity, it is a chance to reduce your work hours by moving to hourly shifts instead of days in the office and nights on call. You can have a good salary while having a life outside of medicine as well. You can hone your clinical skills by concentrating on obstetrics and perhaps emergency gynecology cases as you learn to work in teams; implement systemwide improvement; and have a greater emphasis and potential impact on patient outcomes, satisfaction, and quality.

It is a profession and not just a job. It is one of which I’m proud and love to do. I am convinced that having ob.gyn. hospitalists makes it safer for women. It is an opportunity to get in at the ground floor and help influence our profession’s newest model of care that is changing women’s inpatient care in this country right now and for many years to come.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com.

It’s bittersweet that this will be my last column, but I appreciate the opportunity that this news organization has given to me, and it’s been an honor to share my thoughts about the new ob.gyn. hospitalist model, how it is changing our profession, and the future that lies ahead.

This is an exciting time to be in this rapidly evolving field because this is a new way of delivering health care to women by utilizing board-certified ob.gyns. who are physically present in the hospital. Their presence has led to proven increases in patient safety, a demonstrable reduction in bad outcomes, as well as decreased malpractice costs. Additionally, programs not only lead to increased lifestyle satisfaction for hospitalists, but contribute to reducing private ob.gyns.’ stress and conflict of needing to be in the office and the labor and delivery department.

Although hospital administrators have to pay the considerable gap between the costs of these programs and the amount of billing provided to the hospital by the work the physician hospitalists perform, administrators also are very satisfied. This can be seen by the veritable explosion of new hospitalist programs across the United States. When I began my career as a hospitalist in 2007, I could only find 15 programs, and now there are 200 nationally.

If I speculate and try to imagine 3-5 years in the future, I think there will be ob.gyn. hospitalists in at least 75% of all hospitals delivering 2,000 or more babies per year. That means there will be at least 102 programs employing approximately 612 (6 × 102) hospitalists.

For those of you considering this opportunity, it is a chance to reduce your work hours by moving to hourly shifts instead of days in the office and nights on call. You can have a good salary while having a life outside of medicine as well. You can hone your clinical skills by concentrating on obstetrics and perhaps emergency gynecology cases as you learn to work in teams; implement systemwide improvement; and have a greater emphasis and potential impact on patient outcomes, satisfaction, and quality.

It is a profession and not just a job. It is one of which I’m proud and love to do. I am convinced that having ob.gyn. hospitalists makes it safer for women. It is an opportunity to get in at the ground floor and help influence our profession’s newest model of care that is changing women’s inpatient care in this country right now and for many years to come.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com.

It’s bittersweet that this will be my last column, but I appreciate the opportunity that this news organization has given to me, and it’s been an honor to share my thoughts about the new ob.gyn. hospitalist model, how it is changing our profession, and the future that lies ahead.

This is an exciting time to be in this rapidly evolving field because this is a new way of delivering health care to women by utilizing board-certified ob.gyns. who are physically present in the hospital. Their presence has led to proven increases in patient safety, a demonstrable reduction in bad outcomes, as well as decreased malpractice costs. Additionally, programs not only lead to increased lifestyle satisfaction for hospitalists, but contribute to reducing private ob.gyns.’ stress and conflict of needing to be in the office and the labor and delivery department.

Although hospital administrators have to pay the considerable gap between the costs of these programs and the amount of billing provided to the hospital by the work the physician hospitalists perform, administrators also are very satisfied. This can be seen by the veritable explosion of new hospitalist programs across the United States. When I began my career as a hospitalist in 2007, I could only find 15 programs, and now there are 200 nationally.

If I speculate and try to imagine 3-5 years in the future, I think there will be ob.gyn. hospitalists in at least 75% of all hospitals delivering 2,000 or more babies per year. That means there will be at least 102 programs employing approximately 612 (6 × 102) hospitalists.

For those of you considering this opportunity, it is a chance to reduce your work hours by moving to hourly shifts instead of days in the office and nights on call. You can have a good salary while having a life outside of medicine as well. You can hone your clinical skills by concentrating on obstetrics and perhaps emergency gynecology cases as you learn to work in teams; implement systemwide improvement; and have a greater emphasis and potential impact on patient outcomes, satisfaction, and quality.

It is a profession and not just a job. It is one of which I’m proud and love to do. I am convinced that having ob.gyn. hospitalists makes it safer for women. It is an opportunity to get in at the ground floor and help influence our profession’s newest model of care that is changing women’s inpatient care in this country right now and for many years to come.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com.

This month I’d like to introduce you to two leaders in the ob.gyn. hospitalist field.

The first is Dr. Wayne Farley of Questcare Obstetrics, based in Dallas. It currently has ob.gyn. hospitalist programs in Texas, but has recently expanded to Colorado.

Questcare’s first program was established 5 years ago, and in 2008, Dr. Farley stated: "I’m sure the face of our ob.gyn. hospitalist programs will look much different in 2012-2013." That vision has proven to be very true, and he still believes that Questcare’s programs will continue to evolve with time.

Dr. Farley attributes the program success of Questcare to its focus on the development of perinatal service lines that the facility could not otherwise support. In fact, they have successfully created a variety of these programs for the facilities with which they are currently contracted and hope to expand them in their future contracts.

Questcare Obstetrics is currently expanding perinatal service lines to include high-risk obstetric referral centers. Even more specialized is the Advanced Maternal & Newborn Institute and Specialty Obstetrics Referral Center at Medical City Women’s/Medical City Children’s Hospital in Dallas. This program offers patient-focused outpatient and inpatient care of pregnancies complicated by fetal anomalies and/or chromosomal aberrations.

In addition to high-risk referral centers and specialty clinics, Questcare also has facilitated the development and implementation of a successful maternal transport program.

With this evolutionary change in Questcare’s ob.gyn. hospitalist programs in just 5 years, it should be interesting to see what the next 5 years bring. Questcare Obstetrics is focusing on providing quality ob.gyn. hospitalist programs, while helping expand targeted service lines for its contracted hospitals.

The development of these programs may seem out of the realm of what ob.gyn. hospitalist programs normally bring to a facility, but Questcare’s programs have brought a significant value-added contribution to the hospital without adding to the overall costs of healthcare.

The second person I’d like to introduce is the current president of the Society of OB/GYN Hospitalists (SOGH), Dr. Karenmarie K. Meyer.

Dr. Meyer is a great advocate of the ob.gyn. hospitalist model, and her goals for the fledgling society include defining what an ob.gyn. hospitalist actually is, delineating the criteria for hospitalist core competency; championing patient safety for women in the hospital, emergency department, and in the labor and delivery setting specifically; adding simulation training as part of our core skill set; and documenting our results through research and publications. Dr. Meyer has led significant progress in all of these areas and SOGH has been recognized as an organization whose members will take the lead in determining how ob.gyn. hospital care is provided in the future.

Passionate about the broadening understanding of the model, Dr Meyer recently stated: "Ob.gyn. hospitalists are much more than just an ‘in-house’ doctor available for emergencies. As our membership and visibility continue to increase, others are realizing this as well. Our members are up to date on current management protocols, and our availability to private physicians and their patients has been well recognized in hospitals utilizing our practice model. Our knowledge, consistency, and reliability will continue to define us as the ‘state of the art.’ "

Dr. Meyer and SOGH are continuing to identify hospitalists’ core competency criteria and how these will be assessed and certified. SOGH also has been asked to help define the core criteria for the first fellowship in an ob.gyn. hospitalist discipline, which is being offered by Dr. Anthony Vintzileos at Stony Brook in N.Y.; the fellowship will be established at Winthrop University Hospital, Mineola, N.Y. The second program will be at the Fountain Valley Regional Hospital associated with the University of California, Irvine.

As the ob.gyn. hospitalist model matures and changes, Dr. Farley’s and Dr. Meyer’s contributions are exciting and are helping to define and drive the future of women’s inpatient care across the country today.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com.

This month I’d like to introduce you to two leaders in the ob.gyn. hospitalist field.

The first is Dr. Wayne Farley of Questcare Obstetrics, based in Dallas. It currently has ob.gyn. hospitalist programs in Texas, but has recently expanded to Colorado.

Questcare’s first program was established 5 years ago, and in 2008, Dr. Farley stated: "I’m sure the face of our ob.gyn. hospitalist programs will look much different in 2012-2013." That vision has proven to be very true, and he still believes that Questcare’s programs will continue to evolve with time.

Dr. Farley attributes the program success of Questcare to its focus on the development of perinatal service lines that the facility could not otherwise support. In fact, they have successfully created a variety of these programs for the facilities with which they are currently contracted and hope to expand them in their future contracts.

Questcare Obstetrics is currently expanding perinatal service lines to include high-risk obstetric referral centers. Even more specialized is the Advanced Maternal & Newborn Institute and Specialty Obstetrics Referral Center at Medical City Women’s/Medical City Children’s Hospital in Dallas. This program offers patient-focused outpatient and inpatient care of pregnancies complicated by fetal anomalies and/or chromosomal aberrations.

In addition to high-risk referral centers and specialty clinics, Questcare also has facilitated the development and implementation of a successful maternal transport program.

With this evolutionary change in Questcare’s ob.gyn. hospitalist programs in just 5 years, it should be interesting to see what the next 5 years bring. Questcare Obstetrics is focusing on providing quality ob.gyn. hospitalist programs, while helping expand targeted service lines for its contracted hospitals.

The development of these programs may seem out of the realm of what ob.gyn. hospitalist programs normally bring to a facility, but Questcare’s programs have brought a significant value-added contribution to the hospital without adding to the overall costs of healthcare.

The second person I’d like to introduce is the current president of the Society of OB/GYN Hospitalists (SOGH), Dr. Karenmarie K. Meyer.

Dr. Meyer is a great advocate of the ob.gyn. hospitalist model, and her goals for the fledgling society include defining what an ob.gyn. hospitalist actually is, delineating the criteria for hospitalist core competency; championing patient safety for women in the hospital, emergency department, and in the labor and delivery setting specifically; adding simulation training as part of our core skill set; and documenting our results through research and publications. Dr. Meyer has led significant progress in all of these areas and SOGH has been recognized as an organization whose members will take the lead in determining how ob.gyn. hospital care is provided in the future.

Passionate about the broadening understanding of the model, Dr Meyer recently stated: "Ob.gyn. hospitalists are much more than just an ‘in-house’ doctor available for emergencies. As our membership and visibility continue to increase, others are realizing this as well. Our members are up to date on current management protocols, and our availability to private physicians and their patients has been well recognized in hospitals utilizing our practice model. Our knowledge, consistency, and reliability will continue to define us as the ‘state of the art.’ "

Dr. Meyer and SOGH are continuing to identify hospitalists’ core competency criteria and how these will be assessed and certified. SOGH also has been asked to help define the core criteria for the first fellowship in an ob.gyn. hospitalist discipline, which is being offered by Dr. Anthony Vintzileos at Stony Brook in N.Y.; the fellowship will be established at Winthrop University Hospital, Mineola, N.Y. The second program will be at the Fountain Valley Regional Hospital associated with the University of California, Irvine.

As the ob.gyn. hospitalist model matures and changes, Dr. Farley’s and Dr. Meyer’s contributions are exciting and are helping to define and drive the future of women’s inpatient care across the country today.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com.

This month I’d like to introduce you to two leaders in the ob.gyn. hospitalist field.

The first is Dr. Wayne Farley of Questcare Obstetrics, based in Dallas. It currently has ob.gyn. hospitalist programs in Texas, but has recently expanded to Colorado.

Questcare’s first program was established 5 years ago, and in 2008, Dr. Farley stated: "I’m sure the face of our ob.gyn. hospitalist programs will look much different in 2012-2013." That vision has proven to be very true, and he still believes that Questcare’s programs will continue to evolve with time.

Dr. Farley attributes the program success of Questcare to its focus on the development of perinatal service lines that the facility could not otherwise support. In fact, they have successfully created a variety of these programs for the facilities with which they are currently contracted and hope to expand them in their future contracts.

Questcare Obstetrics is currently expanding perinatal service lines to include high-risk obstetric referral centers. Even more specialized is the Advanced Maternal & Newborn Institute and Specialty Obstetrics Referral Center at Medical City Women’s/Medical City Children’s Hospital in Dallas. This program offers patient-focused outpatient and inpatient care of pregnancies complicated by fetal anomalies and/or chromosomal aberrations.

In addition to high-risk referral centers and specialty clinics, Questcare also has facilitated the development and implementation of a successful maternal transport program.

With this evolutionary change in Questcare’s ob.gyn. hospitalist programs in just 5 years, it should be interesting to see what the next 5 years bring. Questcare Obstetrics is focusing on providing quality ob.gyn. hospitalist programs, while helping expand targeted service lines for its contracted hospitals.

The development of these programs may seem out of the realm of what ob.gyn. hospitalist programs normally bring to a facility, but Questcare’s programs have brought a significant value-added contribution to the hospital without adding to the overall costs of healthcare.

The second person I’d like to introduce is the current president of the Society of OB/GYN Hospitalists (SOGH), Dr. Karenmarie K. Meyer.

Dr. Meyer is a great advocate of the ob.gyn. hospitalist model, and her goals for the fledgling society include defining what an ob.gyn. hospitalist actually is, delineating the criteria for hospitalist core competency; championing patient safety for women in the hospital, emergency department, and in the labor and delivery setting specifically; adding simulation training as part of our core skill set; and documenting our results through research and publications. Dr. Meyer has led significant progress in all of these areas and SOGH has been recognized as an organization whose members will take the lead in determining how ob.gyn. hospital care is provided in the future.

Passionate about the broadening understanding of the model, Dr Meyer recently stated: "Ob.gyn. hospitalists are much more than just an ‘in-house’ doctor available for emergencies. As our membership and visibility continue to increase, others are realizing this as well. Our members are up to date on current management protocols, and our availability to private physicians and their patients has been well recognized in hospitals utilizing our practice model. Our knowledge, consistency, and reliability will continue to define us as the ‘state of the art.’ "

Dr. Meyer and SOGH are continuing to identify hospitalists’ core competency criteria and how these will be assessed and certified. SOGH also has been asked to help define the core criteria for the first fellowship in an ob.gyn. hospitalist discipline, which is being offered by Dr. Anthony Vintzileos at Stony Brook in N.Y.; the fellowship will be established at Winthrop University Hospital, Mineola, N.Y. The second program will be at the Fountain Valley Regional Hospital associated with the University of California, Irvine.

As the ob.gyn. hospitalist model matures and changes, Dr. Farley’s and Dr. Meyer’s contributions are exciting and are helping to define and drive the future of women’s inpatient care across the country today.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com.

One of the reasons I started up my website, ObGynHospitalist.com, was to connect with other ob.gyn. hospitalists that I knew were out there. I wanted to know if they were experiencing the same challenges I was, what their program model looked like, if they were part time or full time, and what their pay and benefits were.

As the website membership grew, it was a logical step to ask members these questions directly.

The first Salary and Employment Survey was sent out in 2011 and had 106 respondents. This year, our third survey had 313 respondents and allowed us to clearly see consistent trends, particularly in ob.gyn. hospitalists’ experience levels, the types of shifts we work, and overall pay and benefits for both part time and full timers.

So, what does a typical ob.gyn. hospitalist look like? Our survey tells us that they are mostly male, between 40 and 59 years old, and are at least 6 years post residency.

Most ob.gyn. hospitalists work in hospitals that average more than 1,000 births per year, with most (45%) working in hospitals with 2,001-3,000 deliveries per year and 19% who work in hospitals with more than 4,000 births per year.

Most describe their primary practice activity as obstetrics with emergency department coverage including emergency gynecologic surgery and inpatient gynecologic consultations. They work full time and have had no change in their employment status over the last 12 months.

The most common full-time work schedule is exclusively 24-hour shifts. Those full-time hospitalists who don’t work 24-hour shifts mostly work 12-hour shifts and are happy with this arrangement.

Ob.gyn. hospitalists are "very satisfied" with their career, variety of work, management, recognition, and professional relationships.

Most work with other ob.gyns. and maternal-fetal medicine physicians only rather than with family practitioners or midwives. Half work as perinatology extenders doing some or most of their deliveries and half use perinatologists only as a consultant, like a private practitioner would.

The majority have ob.gyn. physicians sign out to them, and a third supervise midwives.

Most full-time and part-time hospitalists are hospital employees and are almost evenly split between receiving an hourly gross wage and a salary.

The most common full-time hourly rate (41% in 2012 and 34% in 2013) is $101-$110/hour; 4.5% earn more than $140/hour. Most part-time hospitalists earn less per hour than do full-time hospitalists, with an hourly rate of $91-$100/hour.

The most common full-time salary range (31%) is between $224,000 and $249,000; 4.7% earned between $325,000 and $349,999. The most common part-time salary range is less than $150,000. About 40% of full-time salaried physicians receive incentive compensation based on quality, not production.

A third of respondents stated that they need more physicians in their hospitalist program and that they do not have an adequate emergency backup call system in place. This is an important area for safety, and all programs should address the solution of emergency backup for the hospitalist.

It’s exciting to have this information, not only to know what experience our fellow ob.gyn. hospitalists around the country have, but also it’s interesting to know how other programs are structured, what responsibilities are commonplace, and how our salary and benefits compare with our general ob.gyn. colleagues. The 2013 report can be viewed at ObGynHospitalist.com/news, where you can also find previous survey reports, too.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. 

One of the reasons I started up my website, ObGynHospitalist.com, was to connect with other ob.gyn. hospitalists that I knew were out there. I wanted to know if they were experiencing the same challenges I was, what their program model looked like, if they were part time or full time, and what their pay and benefits were.

As the website membership grew, it was a logical step to ask members these questions directly.

The first Salary and Employment Survey was sent out in 2011 and had 106 respondents. This year, our third survey had 313 respondents and allowed us to clearly see consistent trends, particularly in ob.gyn. hospitalists’ experience levels, the types of shifts we work, and overall pay and benefits for both part time and full timers.

So, what does a typical ob.gyn. hospitalist look like? Our survey tells us that they are mostly male, between 40 and 59 years old, and are at least 6 years post residency.

Most ob.gyn. hospitalists work in hospitals that average more than 1,000 births per year, with most (45%) working in hospitals with 2,001-3,000 deliveries per year and 19% who work in hospitals with more than 4,000 births per year.

Most describe their primary practice activity as obstetrics with emergency department coverage including emergency gynecologic surgery and inpatient gynecologic consultations. They work full time and have had no change in their employment status over the last 12 months.

The most common full-time work schedule is exclusively 24-hour shifts. Those full-time hospitalists who don’t work 24-hour shifts mostly work 12-hour shifts and are happy with this arrangement.

Ob.gyn. hospitalists are "very satisfied" with their career, variety of work, management, recognition, and professional relationships.

Most work with other ob.gyns. and maternal-fetal medicine physicians only rather than with family practitioners or midwives. Half work as perinatology extenders doing some or most of their deliveries and half use perinatologists only as a consultant, like a private practitioner would.

The majority have ob.gyn. physicians sign out to them, and a third supervise midwives.

Most full-time and part-time hospitalists are hospital employees and are almost evenly split between receiving an hourly gross wage and a salary.

The most common full-time hourly rate (41% in 2012 and 34% in 2013) is $101-$110/hour; 4.5% earn more than $140/hour. Most part-time hospitalists earn less per hour than do full-time hospitalists, with an hourly rate of $91-$100/hour.

The most common full-time salary range (31%) is between $224,000 and $249,000; 4.7% earned between $325,000 and $349,999. The most common part-time salary range is less than $150,000. About 40% of full-time salaried physicians receive incentive compensation based on quality, not production.

A third of respondents stated that they need more physicians in their hospitalist program and that they do not have an adequate emergency backup call system in place. This is an important area for safety, and all programs should address the solution of emergency backup for the hospitalist.

It’s exciting to have this information, not only to know what experience our fellow ob.gyn. hospitalists around the country have, but also it’s interesting to know how other programs are structured, what responsibilities are commonplace, and how our salary and benefits compare with our general ob.gyn. colleagues. The 2013 report can be viewed at ObGynHospitalist.com/news, where you can also find previous survey reports, too.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. 

One of the reasons I started up my website, ObGynHospitalist.com, was to connect with other ob.gyn. hospitalists that I knew were out there. I wanted to know if they were experiencing the same challenges I was, what their program model looked like, if they were part time or full time, and what their pay and benefits were.

As the website membership grew, it was a logical step to ask members these questions directly.

The first Salary and Employment Survey was sent out in 2011 and had 106 respondents. This year, our third survey had 313 respondents and allowed us to clearly see consistent trends, particularly in ob.gyn. hospitalists’ experience levels, the types of shifts we work, and overall pay and benefits for both part time and full timers.

So, what does a typical ob.gyn. hospitalist look like? Our survey tells us that they are mostly male, between 40 and 59 years old, and are at least 6 years post residency.

Most ob.gyn. hospitalists work in hospitals that average more than 1,000 births per year, with most (45%) working in hospitals with 2,001-3,000 deliveries per year and 19% who work in hospitals with more than 4,000 births per year.

Most describe their primary practice activity as obstetrics with emergency department coverage including emergency gynecologic surgery and inpatient gynecologic consultations. They work full time and have had no change in their employment status over the last 12 months.

The most common full-time work schedule is exclusively 24-hour shifts. Those full-time hospitalists who don’t work 24-hour shifts mostly work 12-hour shifts and are happy with this arrangement.

Ob.gyn. hospitalists are "very satisfied" with their career, variety of work, management, recognition, and professional relationships.

Most work with other ob.gyns. and maternal-fetal medicine physicians only rather than with family practitioners or midwives. Half work as perinatology extenders doing some or most of their deliveries and half use perinatologists only as a consultant, like a private practitioner would.

The majority have ob.gyn. physicians sign out to them, and a third supervise midwives.

Most full-time and part-time hospitalists are hospital employees and are almost evenly split between receiving an hourly gross wage and a salary.

The most common full-time hourly rate (41% in 2012 and 34% in 2013) is $101-$110/hour; 4.5% earn more than $140/hour. Most part-time hospitalists earn less per hour than do full-time hospitalists, with an hourly rate of $91-$100/hour.

The most common full-time salary range (31%) is between $224,000 and $249,000; 4.7% earned between $325,000 and $349,999. The most common part-time salary range is less than $150,000. About 40% of full-time salaried physicians receive incentive compensation based on quality, not production.

A third of respondents stated that they need more physicians in their hospitalist program and that they do not have an adequate emergency backup call system in place. This is an important area for safety, and all programs should address the solution of emergency backup for the hospitalist.

It’s exciting to have this information, not only to know what experience our fellow ob.gyn. hospitalists around the country have, but also it’s interesting to know how other programs are structured, what responsibilities are commonplace, and how our salary and benefits compare with our general ob.gyn. colleagues. The 2013 report can be viewed at ObGynHospitalist.com/news, where you can also find previous survey reports, too.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of ObGynHospitalist.com. He is a consultant for ob.gyn. hospitalist programs. 

Up to now, I have been commenting mainly on ob.gyn. hospitalists’ impact on labor and delivery, but our surveys show that the majority (64%) of ob.gyn. hospitalists also have responsibility for seeing gynecologic patients in the main emergency department as well as inpatient consultation.

Most gynecologic emergencies are as you would suspect: threatened miscarriage, ectopic pregnancy, pelvic inflammatory disease, and, to a lesser extent, torsion of benign tumors as well as the occasional malignancy, and the common vague abdominal pain syndromes. Ob.gyn. hospitalists provide the main emergency department with the type of service that they provide in labor and delivery (L&D) triage or the obstetric ED: immediate or at least rapid response, expert clinical care, and the ability to work with the team in the ED or with other team members such as surgeons in the case of major trauma involving either pregnancy or gynecologic organs. This rapid response results in increased patient satisfaction as well as a more efficient ED.

However, having an ob.gyn. hospitalist cover the ED comes at a cost, as it physically takes him or her away from covering potential emergencies in the L&D area. Some hospitals get around this problem by allowing the ob.gyn. hospitalist to only go to the ED when they’re unoccupied; or if they make a diagnosis requiring surgery, they will call the on-call gynecologic surgeon so that the ob.gyn. hospitalist is not in the operating room with a case just when they’re needed for a shoulder dystocia or prolapsed cord in L&D.

This compromise of allowing diagnosis but not surgical treatment is a good one because even though the main ED is frequently geographically separate from L&D, the ob.gyn. hospitalists can usually rapidly leave the main ED to respond, while they could not provide the same response if they were in the middle of a surgical case. Having a backup gynecologic surgeon on call also provides a mechanism for outpatient follow-up for a medically treated gynecologic emergency patient.

Well-run programs also have an obstetric physician on backup call for follow-up of unassigned outpatient obstetric patients who need to be seen after triage or obstetric ED visits. More importantly, these programs have a backup physician if the ob.gyn. hospitalist gets either too busy or too fatigued. However, our most recent ob.gyn. hospitalist.com employment survey shows that between 35% and 45% of programs do not have an adequate emergency backup system in place to cover the hospitalists (www.obgynhospitalist.com).

Rapid and easily obtained gynecologic consultation also helps with improved patient care, diagnosis, treatment, and turnover of inpatient beds. With in-house ob.gyn. hospitalists, the days of internists, family practitioners, and traditional hospitalists having to wait until after office hours for a gynecologist to see an inpatient are over. Traditionally, that consultation would take place at 6 p.m. or 7 p.m., and then additional ordered diagnostic imaging might not take place until the next day, adding unnecessary delays in diagnosis and causing longer hospital stays than necessary.

Gynecologic responsibilities add to the body of knowledge that ob.gyn. hospitalists need to be skilled at, especially with diagnosis and medical treatment. However, requiring hospitalists to provide gynecologic coverage also emphasizes the potential challenge of how to maintain superb gynecologic surgical technique. This is difficult with low volumes of surgical cases. Once again, this problem can be eliminated if there’s a gynecologic surgeon to do the work in the operating room. This is also an area that is of particular interest to the Society of OB/GYN Hospitalists as they discuss and decide which skills and competencies hospitalists must possess and maintain.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com. To see more Hospitalist Stat columns, visit obgynnews.com/views/obgyn-hospitalist-stat.html.

Up to now, I have been commenting mainly on ob.gyn. hospitalists’ impact on labor and delivery, but our surveys show that the majority (64%) of ob.gyn. hospitalists also have responsibility for seeing gynecologic patients in the main emergency department as well as inpatient consultation.

Most gynecologic emergencies are as you would suspect: threatened miscarriage, ectopic pregnancy, pelvic inflammatory disease, and, to a lesser extent, torsion of benign tumors as well as the occasional malignancy, and the common vague abdominal pain syndromes. Ob.gyn. hospitalists provide the main emergency department with the type of service that they provide in labor and delivery (L&D) triage or the obstetric ED: immediate or at least rapid response, expert clinical care, and the ability to work with the team in the ED or with other team members such as surgeons in the case of major trauma involving either pregnancy or gynecologic organs. This rapid response results in increased patient satisfaction as well as a more efficient ED.

However, having an ob.gyn. hospitalist cover the ED comes at a cost, as it physically takes him or her away from covering potential emergencies in the L&D area. Some hospitals get around this problem by allowing the ob.gyn. hospitalist to only go to the ED when they’re unoccupied; or if they make a diagnosis requiring surgery, they will call the on-call gynecologic surgeon so that the ob.gyn. hospitalist is not in the operating room with a case just when they’re needed for a shoulder dystocia or prolapsed cord in L&D.

This compromise of allowing diagnosis but not surgical treatment is a good one because even though the main ED is frequently geographically separate from L&D, the ob.gyn. hospitalists can usually rapidly leave the main ED to respond, while they could not provide the same response if they were in the middle of a surgical case. Having a backup gynecologic surgeon on call also provides a mechanism for outpatient follow-up for a medically treated gynecologic emergency patient.

Well-run programs also have an obstetric physician on backup call for follow-up of unassigned outpatient obstetric patients who need to be seen after triage or obstetric ED visits. More importantly, these programs have a backup physician if the ob.gyn. hospitalist gets either too busy or too fatigued. However, our most recent ob.gyn. hospitalist.com employment survey shows that between 35% and 45% of programs do not have an adequate emergency backup system in place to cover the hospitalists (www.obgynhospitalist.com).

Rapid and easily obtained gynecologic consultation also helps with improved patient care, diagnosis, treatment, and turnover of inpatient beds. With in-house ob.gyn. hospitalists, the days of internists, family practitioners, and traditional hospitalists having to wait until after office hours for a gynecologist to see an inpatient are over. Traditionally, that consultation would take place at 6 p.m. or 7 p.m., and then additional ordered diagnostic imaging might not take place until the next day, adding unnecessary delays in diagnosis and causing longer hospital stays than necessary.

Gynecologic responsibilities add to the body of knowledge that ob.gyn. hospitalists need to be skilled at, especially with diagnosis and medical treatment. However, requiring hospitalists to provide gynecologic coverage also emphasizes the potential challenge of how to maintain superb gynecologic surgical technique. This is difficult with low volumes of surgical cases. Once again, this problem can be eliminated if there’s a gynecologic surgeon to do the work in the operating room. This is also an area that is of particular interest to the Society of OB/GYN Hospitalists as they discuss and decide which skills and competencies hospitalists must possess and maintain.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com. To see more Hospitalist Stat columns, visit obgynnews.com/views/obgyn-hospitalist-stat.html.

Up to now, I have been commenting mainly on ob.gyn. hospitalists’ impact on labor and delivery, but our surveys show that the majority (64%) of ob.gyn. hospitalists also have responsibility for seeing gynecologic patients in the main emergency department as well as inpatient consultation.

Most gynecologic emergencies are as you would suspect: threatened miscarriage, ectopic pregnancy, pelvic inflammatory disease, and, to a lesser extent, torsion of benign tumors as well as the occasional malignancy, and the common vague abdominal pain syndromes. Ob.gyn. hospitalists provide the main emergency department with the type of service that they provide in labor and delivery (L&D) triage or the obstetric ED: immediate or at least rapid response, expert clinical care, and the ability to work with the team in the ED or with other team members such as surgeons in the case of major trauma involving either pregnancy or gynecologic organs. This rapid response results in increased patient satisfaction as well as a more efficient ED.

However, having an ob.gyn. hospitalist cover the ED comes at a cost, as it physically takes him or her away from covering potential emergencies in the L&D area. Some hospitals get around this problem by allowing the ob.gyn. hospitalist to only go to the ED when they’re unoccupied; or if they make a diagnosis requiring surgery, they will call the on-call gynecologic surgeon so that the ob.gyn. hospitalist is not in the operating room with a case just when they’re needed for a shoulder dystocia or prolapsed cord in L&D.

This compromise of allowing diagnosis but not surgical treatment is a good one because even though the main ED is frequently geographically separate from L&D, the ob.gyn. hospitalists can usually rapidly leave the main ED to respond, while they could not provide the same response if they were in the middle of a surgical case. Having a backup gynecologic surgeon on call also provides a mechanism for outpatient follow-up for a medically treated gynecologic emergency patient.

Well-run programs also have an obstetric physician on backup call for follow-up of unassigned outpatient obstetric patients who need to be seen after triage or obstetric ED visits. More importantly, these programs have a backup physician if the ob.gyn. hospitalist gets either too busy or too fatigued. However, our most recent ob.gyn. hospitalist.com employment survey shows that between 35% and 45% of programs do not have an adequate emergency backup system in place to cover the hospitalists (www.obgynhospitalist.com).

Rapid and easily obtained gynecologic consultation also helps with improved patient care, diagnosis, treatment, and turnover of inpatient beds. With in-house ob.gyn. hospitalists, the days of internists, family practitioners, and traditional hospitalists having to wait until after office hours for a gynecologist to see an inpatient are over. Traditionally, that consultation would take place at 6 p.m. or 7 p.m., and then additional ordered diagnostic imaging might not take place until the next day, adding unnecessary delays in diagnosis and causing longer hospital stays than necessary.

Gynecologic responsibilities add to the body of knowledge that ob.gyn. hospitalists need to be skilled at, especially with diagnosis and medical treatment. However, requiring hospitalists to provide gynecologic coverage also emphasizes the potential challenge of how to maintain superb gynecologic surgical technique. This is difficult with low volumes of surgical cases. Once again, this problem can be eliminated if there’s a gynecologic surgeon to do the work in the operating room. This is also an area that is of particular interest to the Society of OB/GYN Hospitalists as they discuss and decide which skills and competencies hospitalists must possess and maintain.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of OB/GYN Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@frontlinemedcom.com. To see more Hospitalist Stat columns, visit obgynnews.com/views/obgyn-hospitalist-stat.html.

The only difference between ob.gyn. hospitalists and general ob.gyns. is work location, right? We all undergo the same residency training, pass the same boards to become board certified, and you have to be a general ob.gyn. to become a hospitalist after all. So, in one sense, there are no differences.

In addition to clinical skills, however, hospitalists do differ. As I outlined in my column "Ob.Gyn. Hospitalist Character Traits," a hospitalist must be a seasoned professional and a team player, be willing to serve, inspire trust, be a good communicator, and be trained and incentivized to implement system-wide improvements.

Along with character traits, it is generally acknowledged that ob.gyn. hospitalists possess a specific set of core competencies. I began trying to formally define these during my first American College of Obstetricians and Gynecologists annual clinical meeting (ACM) clinical seminar in 2010.

Dr. Bob Fagnant expanded on the initial ideas in a presentation at the second Ob.Gyn. Hospitalists’ special interest group meeting at the 2011 ACOG ACM in Washington, D.C. His presentation was well received, drew much interest from a large audience, and has initiated discussion that continues. The Society of Ob.Gyn. Hospitalists (SOGH) also has dedicated itself to defining the core competencies, but as this is such a new model of ob.gyn. practice, there is much yet to be debated, and discussion should be expected and encouraged.

As stated above, the ideal hospitalist should be a seasoned professional. ObGynHospitalist.com employment surveys from the past 2 years showed that only 7% of ob.gyn. hospitalists started hospitalist work within 5 years of completing their residency. I think all of us agree that it is very difficult for a new residency graduate to acquire the skills and experience to step in and perform as a hospitalist. Not to say that it’s impossible, just very difficult in light of most residency volumes combined with residency hour restrictions.

One idea that I have heard several academic centers beginning to discuss is that of a fellowship for ob.gyn. hospitalists. Advanced training in a fellowship could provide more experience for new graduates, but it would be especially helpful for experienced, board-certified ob.gyn. hospitalists to hone not only their clinical skills, but also learn the administrative, simulation teaching, team leadership, and information management skills to take existing hospitalist programs from good to great and to start new programs at the highest skill level.

This idea is in its infancy and faces obstacles. Most experienced ob.gyns. may be unwilling to leave their current private practice positions and return to the lifestyle, hours, and, especially, the payoff of a fellow. However, there may be creative solutions similar to executive MBA programs, such as online learning, reviewing curricula designed by the academic center, and periodically traveling to the center for weekends or more prolonged times for the hands-on clinical training and experience portion over a year or two. Introduction of a new additional program needs to be handled carefully because such a program for hospitalists cannot reduce or take away from the clinical training experience of current residents and maternal-fetal medicine fellows.

Like the development of the core competencies necessary for ob.gyn. hospitalists, it will be fascinating to watch the development of academic programs for ob.gyn. hospitalist fellows. It will be exciting to see the first graduates and even more exciting to see the first board-certified ob.gyn. hospitalist in a new subspecialty. Will an old hospitalist like me get grandfathered in if I can pass the new (yet to be determined) American Board of Obstetricians and Gynecologists’ board certification for ob.gyn. hospitalists?

We are lucky to have the SOGH in a position to hear discussion and debate and to advocate for commonly agreed-upon positions. There are so many questions to answer to define the difference between general ob.gyns. and hospitalist ob.gyns., but we are on the cusp of not an evolution in care for women in the hospital, but a revolution. The future is unknown, but the direction from the known is extremely positive. Not only is patient care becoming safer, but the system is becoming safer and more cost efficient while at the same time improving the lifestyle of the general ob.gyn. practitioner. This last sentence will be backed up by data and experience in the near future, I predict.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. This column, "Ob.Gyn. Hospitalist – STAT!" appears regularly in Ob.Gyn. News. E-mail Dr. Olson at obnews@elsevier.com.

The only difference between ob.gyn. hospitalists and general ob.gyns. is work location, right? We all undergo the same residency training, pass the same boards to become board certified, and you have to be a general ob.gyn. to become a hospitalist after all. So, in one sense, there are no differences.

In addition to clinical skills, however, hospitalists do differ. As I outlined in my column "Ob.Gyn. Hospitalist Character Traits," a hospitalist must be a seasoned professional and a team player, be willing to serve, inspire trust, be a good communicator, and be trained and incentivized to implement system-wide improvements.

Along with character traits, it is generally acknowledged that ob.gyn. hospitalists possess a specific set of core competencies. I began trying to formally define these during my first American College of Obstetricians and Gynecologists annual clinical meeting (ACM) clinical seminar in 2010.

Dr. Bob Fagnant expanded on the initial ideas in a presentation at the second Ob.Gyn. Hospitalists’ special interest group meeting at the 2011 ACOG ACM in Washington, D.C. His presentation was well received, drew much interest from a large audience, and has initiated discussion that continues. The Society of Ob.Gyn. Hospitalists (SOGH) also has dedicated itself to defining the core competencies, but as this is such a new model of ob.gyn. practice, there is much yet to be debated, and discussion should be expected and encouraged.

As stated above, the ideal hospitalist should be a seasoned professional. ObGynHospitalist.com employment surveys from the past 2 years showed that only 7% of ob.gyn. hospitalists started hospitalist work within 5 years of completing their residency. I think all of us agree that it is very difficult for a new residency graduate to acquire the skills and experience to step in and perform as a hospitalist. Not to say that it’s impossible, just very difficult in light of most residency volumes combined with residency hour restrictions.

One idea that I have heard several academic centers beginning to discuss is that of a fellowship for ob.gyn. hospitalists. Advanced training in a fellowship could provide more experience for new graduates, but it would be especially helpful for experienced, board-certified ob.gyn. hospitalists to hone not only their clinical skills, but also learn the administrative, simulation teaching, team leadership, and information management skills to take existing hospitalist programs from good to great and to start new programs at the highest skill level.

This idea is in its infancy and faces obstacles. Most experienced ob.gyns. may be unwilling to leave their current private practice positions and return to the lifestyle, hours, and, especially, the payoff of a fellow. However, there may be creative solutions similar to executive MBA programs, such as online learning, reviewing curricula designed by the academic center, and periodically traveling to the center for weekends or more prolonged times for the hands-on clinical training and experience portion over a year or two. Introduction of a new additional program needs to be handled carefully because such a program for hospitalists cannot reduce or take away from the clinical training experience of current residents and maternal-fetal medicine fellows.

Like the development of the core competencies necessary for ob.gyn. hospitalists, it will be fascinating to watch the development of academic programs for ob.gyn. hospitalist fellows. It will be exciting to see the first graduates and even more exciting to see the first board-certified ob.gyn. hospitalist in a new subspecialty. Will an old hospitalist like me get grandfathered in if I can pass the new (yet to be determined) American Board of Obstetricians and Gynecologists’ board certification for ob.gyn. hospitalists?

We are lucky to have the SOGH in a position to hear discussion and debate and to advocate for commonly agreed-upon positions. There are so many questions to answer to define the difference between general ob.gyns. and hospitalist ob.gyns., but we are on the cusp of not an evolution in care for women in the hospital, but a revolution. The future is unknown, but the direction from the known is extremely positive. Not only is patient care becoming safer, but the system is becoming safer and more cost efficient while at the same time improving the lifestyle of the general ob.gyn. practitioner. This last sentence will be backed up by data and experience in the near future, I predict.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. This column, "Ob.Gyn. Hospitalist – STAT!" appears regularly in Ob.Gyn. News. E-mail Dr. Olson at obnews@elsevier.com.

The only difference between ob.gyn. hospitalists and general ob.gyns. is work location, right? We all undergo the same residency training, pass the same boards to become board certified, and you have to be a general ob.gyn. to become a hospitalist after all. So, in one sense, there are no differences.

In addition to clinical skills, however, hospitalists do differ. As I outlined in my column "Ob.Gyn. Hospitalist Character Traits," a hospitalist must be a seasoned professional and a team player, be willing to serve, inspire trust, be a good communicator, and be trained and incentivized to implement system-wide improvements.

Along with character traits, it is generally acknowledged that ob.gyn. hospitalists possess a specific set of core competencies. I began trying to formally define these during my first American College of Obstetricians and Gynecologists annual clinical meeting (ACM) clinical seminar in 2010.

Dr. Bob Fagnant expanded on the initial ideas in a presentation at the second Ob.Gyn. Hospitalists’ special interest group meeting at the 2011 ACOG ACM in Washington, D.C. His presentation was well received, drew much interest from a large audience, and has initiated discussion that continues. The Society of Ob.Gyn. Hospitalists (SOGH) also has dedicated itself to defining the core competencies, but as this is such a new model of ob.gyn. practice, there is much yet to be debated, and discussion should be expected and encouraged.

As stated above, the ideal hospitalist should be a seasoned professional. ObGynHospitalist.com employment surveys from the past 2 years showed that only 7% of ob.gyn. hospitalists started hospitalist work within 5 years of completing their residency. I think all of us agree that it is very difficult for a new residency graduate to acquire the skills and experience to step in and perform as a hospitalist. Not to say that it’s impossible, just very difficult in light of most residency volumes combined with residency hour restrictions.

One idea that I have heard several academic centers beginning to discuss is that of a fellowship for ob.gyn. hospitalists. Advanced training in a fellowship could provide more experience for new graduates, but it would be especially helpful for experienced, board-certified ob.gyn. hospitalists to hone not only their clinical skills, but also learn the administrative, simulation teaching, team leadership, and information management skills to take existing hospitalist programs from good to great and to start new programs at the highest skill level.

This idea is in its infancy and faces obstacles. Most experienced ob.gyns. may be unwilling to leave their current private practice positions and return to the lifestyle, hours, and, especially, the payoff of a fellow. However, there may be creative solutions similar to executive MBA programs, such as online learning, reviewing curricula designed by the academic center, and periodically traveling to the center for weekends or more prolonged times for the hands-on clinical training and experience portion over a year or two. Introduction of a new additional program needs to be handled carefully because such a program for hospitalists cannot reduce or take away from the clinical training experience of current residents and maternal-fetal medicine fellows.

Like the development of the core competencies necessary for ob.gyn. hospitalists, it will be fascinating to watch the development of academic programs for ob.gyn. hospitalist fellows. It will be exciting to see the first graduates and even more exciting to see the first board-certified ob.gyn. hospitalist in a new subspecialty. Will an old hospitalist like me get grandfathered in if I can pass the new (yet to be determined) American Board of Obstetricians and Gynecologists’ board certification for ob.gyn. hospitalists?

We are lucky to have the SOGH in a position to hear discussion and debate and to advocate for commonly agreed-upon positions. There are so many questions to answer to define the difference between general ob.gyns. and hospitalist ob.gyns., but we are on the cusp of not an evolution in care for women in the hospital, but a revolution. The future is unknown, but the direction from the known is extremely positive. Not only is patient care becoming safer, but the system is becoming safer and more cost efficient while at the same time improving the lifestyle of the general ob.gyn. practitioner. This last sentence will be backed up by data and experience in the near future, I predict.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. This column, "Ob.Gyn. Hospitalist – STAT!" appears regularly in Ob.Gyn. News. E-mail Dr. Olson at obnews@elsevier.com.

The reason that hospitals develop ob.gyn. hospitalist programs or hire staffing companies to do it for them is for patient safety. Labor and Delivery handles a plethora of situations: from the straightforward, almost mundane deliveries to the unpredictable emergencies, which can quickly lead to bad outcomes. Frequently, the time it takes for a general ob.gyn., family physician, or midwife to get from home or the office to the hospital can delay treatment.

A recent study by Dr. Larry Veltman and Darrell Ranum of The Doctors Company recommends increased physician readiness as a way to help reduce "delay in treatment of fetal distress" ("Delay in Treatment of Fetal Distress," The Doctor’s Advocate 2012;3rd quarter:8-9).

It’s my experience that having a dedicated, experienced, board-certified ob.gyn. on-site and immediately available can eliminate this delay and often the potential bad outcome.

Ob.gyn. hospitalists are in the best position to directly and immediately affect patient safety while improving efficiency and quality of care. They can start the treatment, such as a crash cesarean section for an abruption, while awaiting the arrival of a private practitioner. This shortened response time leads to better outcomes. This makes common sense, and while there are a multitude of anecdotal examples, we need to conduct more formal studies and collect data to prove this point.

Another great example is from my hospital, where a number of family physicians and midwives have obstetric privileges. In the past, they were vulnerable to being there without backup. They knew that if they had a shoulder dystocia, there would be enough time to ask for help. They were reluctant to call in an ob.gyn., especially in the middle of the night unnecessarily. Now with ob.gyn. hospitalists on-site, they frequently ask me to stand by if they’re worried about possible shoulder dystocia. My approach to this is that I stay outside the labor room door, and if I hear the baby cry I go back to my call room, but if I hear the doctor cry I go in to help.

Private practitioners frequently ask for my help on the interpretation of fetal monitor strips. The private ob.gyns. also discuss difficult cases and specifically ask for surgical assistance on complicated or high-risk cesarean sections. This direct, informal access to experienced ob.gyns. and open communication leads directly to increased patient safety and better outcomes.

The Doctors Company study also stated that improved communications could help address unnecessary delays in "fetal distress" treatment. Hospitalists can help with this, because they are relied upon to integrate and coordinate change when necessary, as they regularly work across the spectrum with neonatologists, anesthesiologists, and others.

Ob.gyn. hospitalists also help the nursing staff: They have the time to stop and talk with the nurses, provide them with immediate and ongoing education, provide immediate patient evaluations in the absence of private physicians, help interpret fetal monitor tracings, and assist in unanticipated situations that often arise. One of our functions is to empower the nurses. Strong, confident nurses who can speak up with their concerns to sometimes intimidating physicians can only make it safer for women in the hospital.

Hospitalists are also a source for implementing hospital protocols, and their constant in-house presence enables them to help advocate for systemwide quality improvement, leading to a safer environment for all patients.

Additionally, when money is the bottom line, increased safety through ob.gyn. hospitalist programs has the potential to offset their expense by reducing the costs associated with investigating and defending malpractice claims. This is good for patients, physicians, and hospitals alike.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

The reason that hospitals develop ob.gyn. hospitalist programs or hire staffing companies to do it for them is for patient safety. Labor and Delivery handles a plethora of situations: from the straightforward, almost mundane deliveries to the unpredictable emergencies, which can quickly lead to bad outcomes. Frequently, the time it takes for a general ob.gyn., family physician, or midwife to get from home or the office to the hospital can delay treatment.

A recent study by Dr. Larry Veltman and Darrell Ranum of The Doctors Company recommends increased physician readiness as a way to help reduce "delay in treatment of fetal distress" ("Delay in Treatment of Fetal Distress," The Doctor’s Advocate 2012;3rd quarter:8-9).

It’s my experience that having a dedicated, experienced, board-certified ob.gyn. on-site and immediately available can eliminate this delay and often the potential bad outcome.

Ob.gyn. hospitalists are in the best position to directly and immediately affect patient safety while improving efficiency and quality of care. They can start the treatment, such as a crash cesarean section for an abruption, while awaiting the arrival of a private practitioner. This shortened response time leads to better outcomes. This makes common sense, and while there are a multitude of anecdotal examples, we need to conduct more formal studies and collect data to prove this point.

Another great example is from my hospital, where a number of family physicians and midwives have obstetric privileges. In the past, they were vulnerable to being there without backup. They knew that if they had a shoulder dystocia, there would be enough time to ask for help. They were reluctant to call in an ob.gyn., especially in the middle of the night unnecessarily. Now with ob.gyn. hospitalists on-site, they frequently ask me to stand by if they’re worried about possible shoulder dystocia. My approach to this is that I stay outside the labor room door, and if I hear the baby cry I go back to my call room, but if I hear the doctor cry I go in to help.

Private practitioners frequently ask for my help on the interpretation of fetal monitor strips. The private ob.gyns. also discuss difficult cases and specifically ask for surgical assistance on complicated or high-risk cesarean sections. This direct, informal access to experienced ob.gyns. and open communication leads directly to increased patient safety and better outcomes.

The Doctors Company study also stated that improved communications could help address unnecessary delays in "fetal distress" treatment. Hospitalists can help with this, because they are relied upon to integrate and coordinate change when necessary, as they regularly work across the spectrum with neonatologists, anesthesiologists, and others.

Ob.gyn. hospitalists also help the nursing staff: They have the time to stop and talk with the nurses, provide them with immediate and ongoing education, provide immediate patient evaluations in the absence of private physicians, help interpret fetal monitor tracings, and assist in unanticipated situations that often arise. One of our functions is to empower the nurses. Strong, confident nurses who can speak up with their concerns to sometimes intimidating physicians can only make it safer for women in the hospital.

Hospitalists are also a source for implementing hospital protocols, and their constant in-house presence enables them to help advocate for systemwide quality improvement, leading to a safer environment for all patients.

Additionally, when money is the bottom line, increased safety through ob.gyn. hospitalist programs has the potential to offset their expense by reducing the costs associated with investigating and defending malpractice claims. This is good for patients, physicians, and hospitals alike.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

The reason that hospitals develop ob.gyn. hospitalist programs or hire staffing companies to do it for them is for patient safety. Labor and Delivery handles a plethora of situations: from the straightforward, almost mundane deliveries to the unpredictable emergencies, which can quickly lead to bad outcomes. Frequently, the time it takes for a general ob.gyn., family physician, or midwife to get from home or the office to the hospital can delay treatment.

A recent study by Dr. Larry Veltman and Darrell Ranum of The Doctors Company recommends increased physician readiness as a way to help reduce "delay in treatment of fetal distress" ("Delay in Treatment of Fetal Distress," The Doctor’s Advocate 2012;3rd quarter:8-9).

It’s my experience that having a dedicated, experienced, board-certified ob.gyn. on-site and immediately available can eliminate this delay and often the potential bad outcome.

Ob.gyn. hospitalists are in the best position to directly and immediately affect patient safety while improving efficiency and quality of care. They can start the treatment, such as a crash cesarean section for an abruption, while awaiting the arrival of a private practitioner. This shortened response time leads to better outcomes. This makes common sense, and while there are a multitude of anecdotal examples, we need to conduct more formal studies and collect data to prove this point.

Another great example is from my hospital, where a number of family physicians and midwives have obstetric privileges. In the past, they were vulnerable to being there without backup. They knew that if they had a shoulder dystocia, there would be enough time to ask for help. They were reluctant to call in an ob.gyn., especially in the middle of the night unnecessarily. Now with ob.gyn. hospitalists on-site, they frequently ask me to stand by if they’re worried about possible shoulder dystocia. My approach to this is that I stay outside the labor room door, and if I hear the baby cry I go back to my call room, but if I hear the doctor cry I go in to help.

Private practitioners frequently ask for my help on the interpretation of fetal monitor strips. The private ob.gyns. also discuss difficult cases and specifically ask for surgical assistance on complicated or high-risk cesarean sections. This direct, informal access to experienced ob.gyns. and open communication leads directly to increased patient safety and better outcomes.

The Doctors Company study also stated that improved communications could help address unnecessary delays in "fetal distress" treatment. Hospitalists can help with this, because they are relied upon to integrate and coordinate change when necessary, as they regularly work across the spectrum with neonatologists, anesthesiologists, and others.

Ob.gyn. hospitalists also help the nursing staff: They have the time to stop and talk with the nurses, provide them with immediate and ongoing education, provide immediate patient evaluations in the absence of private physicians, help interpret fetal monitor tracings, and assist in unanticipated situations that often arise. One of our functions is to empower the nurses. Strong, confident nurses who can speak up with their concerns to sometimes intimidating physicians can only make it safer for women in the hospital.

Hospitalists are also a source for implementing hospital protocols, and their constant in-house presence enables them to help advocate for systemwide quality improvement, leading to a safer environment for all patients.

Additionally, when money is the bottom line, increased safety through ob.gyn. hospitalist programs has the potential to offset their expense by reducing the costs associated with investigating and defending malpractice claims. This is good for patients, physicians, and hospitals alike.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

What do you get when you put 83 enthusiastic ob.gyn. hospitalists, generalists, and administrators together in one big conference room in Denver? You get a lot of fun and great, relevant clinical information essential for hospitalists working all across the country today.

Even though I’ve been an ob.gyn. for 35 years and a hospitalist for the last 5, this annual clinical meeting taught me new business and clinical information. As our model of practice develops, we also can learn much from each other, and this annual event allows us to meet face-to-face to discuss our common problems, share workable solutions, and socialize.

Here were some of the meeting highlights for me:

Dr. Richard Porreco of Rocky Mountain Hospital for Children, Denver, reminded me to respect the condition of placenta percreta, and his expert advice on ways to deal with it was invaluable. He also reviewed peripartum intensive care and discussed the possible future roles for ob.gyn. hospitalists in leading critical care of these patients.

Dr. John Hobbins of the University of Colorado, Denver, explained the use of sonography in labor and delivery, an area that we will all need to pay attention to in the near future. Personally, I only use ultrasound in triage and to identify fetal position in labor, but he showed some of the benefits of using it to assist prior to operative delivery.

Darrell Ranum, J.D., regional vice president of patient safety for The Doctors Company in Columbus, Ohio, covered the factors that result in the delay in treatment of fetal heart rate abnormalities. His conclusion was that communication issues and the delay in the arrival of the physician can both be alleviated by having an ob.gyn. hospitalist on-site. This is something that we still need more data to prove, but his closed claims data was convincing.

Dr. Arthur Townsend spoke about the importance of hospitalist statistics. Collecting statistics is difficult, and hospitalists may not see the benefits. However, Dr. Townsend demonstrated how to make gathering statistics easier with his Web-based solution and the value in doing so, which we need to embrace to prove the difference we make as hospitalists.

Ob Hospitalist Group hosted the lunchtime lecture by Miranda Klassen on amniotic fluid embolism. Miranda, who founded the Amniotic Embolism Foundation (afesupport.org), is not only a survivor, she has made it her mission to educate physicians to identify and rapidly respond to this potentially fatal and often misdiagnosed condition. This was very worthwhile reviewing.

Dr. Stan Davis of Edina, Minn., spoke about the human factors in labor and delivery. He was able to communicate the TeamSTEPPS system in a concise and effective way that made it easier to understand and more relevant for me than all the other times I’ve been exposed to this complex subject.

Dr. John Nelson (nelsonflores.com), cofounder of the Society of Hospital Medicine (hospitalmedicine.org), spoke about starting and operating a professional society, and lessons learned from medical hospitalists so that, hopefully, we can avoid their early missteps.

Prior to the conference, 56 ob.gyns. participated in The Doctors Company’s highly specialized emergency obstetric simulation workshop. One of the highlights of this workshop was the attendance of Professor Christopher B. Lynch, who flew in from the United Kingdom to personally demonstrate his B-Lynch suture technique for the control of postpartum hemorrhage. In addition, GE sponsored a concurrent hands-on ultrasound in labor and delivery course with live models. It was a fantastic mix of learning and practicing old and new skills.

Questcare hosted a welcome reception, which gave attendees an informal chance to meet and discuss problems and solutions related to being hospitalists. This also gave general ob.gyns. who aspire to be hospitalists a chance to ask seasoned hospitalists about their experiences. This is what the annual meeting was all about: networking, talking with peers, and knowing that we are not alone out there practicing this new model of ob.gyn. medicine.

SOGH will hold its third annual clinical meeting in Denver from Sept. 19 to Sept. 21, 2013. Save the date to come and learn more about both the clinical and the business aspects of being an ob.gyn. hospitalist.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob/Gyn Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

What do you get when you put 83 enthusiastic ob.gyn. hospitalists, generalists, and administrators together in one big conference room in Denver? You get a lot of fun and great, relevant clinical information essential for hospitalists working all across the country today.

Even though I’ve been an ob.gyn. for 35 years and a hospitalist for the last 5, this annual clinical meeting taught me new business and clinical information. As our model of practice develops, we also can learn much from each other, and this annual event allows us to meet face-to-face to discuss our common problems, share workable solutions, and socialize.

Here were some of the meeting highlights for me:

Dr. Richard Porreco of Rocky Mountain Hospital for Children, Denver, reminded me to respect the condition of placenta percreta, and his expert advice on ways to deal with it was invaluable. He also reviewed peripartum intensive care and discussed the possible future roles for ob.gyn. hospitalists in leading critical care of these patients.

Dr. John Hobbins of the University of Colorado, Denver, explained the use of sonography in labor and delivery, an area that we will all need to pay attention to in the near future. Personally, I only use ultrasound in triage and to identify fetal position in labor, but he showed some of the benefits of using it to assist prior to operative delivery.

Darrell Ranum, J.D., regional vice president of patient safety for The Doctors Company in Columbus, Ohio, covered the factors that result in the delay in treatment of fetal heart rate abnormalities. His conclusion was that communication issues and the delay in the arrival of the physician can both be alleviated by having an ob.gyn. hospitalist on-site. This is something that we still need more data to prove, but his closed claims data was convincing.

Dr. Arthur Townsend spoke about the importance of hospitalist statistics. Collecting statistics is difficult, and hospitalists may not see the benefits. However, Dr. Townsend demonstrated how to make gathering statistics easier with his Web-based solution and the value in doing so, which we need to embrace to prove the difference we make as hospitalists.

Ob Hospitalist Group hosted the lunchtime lecture by Miranda Klassen on amniotic fluid embolism. Miranda, who founded the Amniotic Embolism Foundation (afesupport.org), is not only a survivor, she has made it her mission to educate physicians to identify and rapidly respond to this potentially fatal and often misdiagnosed condition. This was very worthwhile reviewing.

Dr. Stan Davis of Edina, Minn., spoke about the human factors in labor and delivery. He was able to communicate the TeamSTEPPS system in a concise and effective way that made it easier to understand and more relevant for me than all the other times I’ve been exposed to this complex subject.

Dr. John Nelson (nelsonflores.com), cofounder of the Society of Hospital Medicine (hospitalmedicine.org), spoke about starting and operating a professional society, and lessons learned from medical hospitalists so that, hopefully, we can avoid their early missteps.

Prior to the conference, 56 ob.gyns. participated in The Doctors Company’s highly specialized emergency obstetric simulation workshop. One of the highlights of this workshop was the attendance of Professor Christopher B. Lynch, who flew in from the United Kingdom to personally demonstrate his B-Lynch suture technique for the control of postpartum hemorrhage. In addition, GE sponsored a concurrent hands-on ultrasound in labor and delivery course with live models. It was a fantastic mix of learning and practicing old and new skills.

Questcare hosted a welcome reception, which gave attendees an informal chance to meet and discuss problems and solutions related to being hospitalists. This also gave general ob.gyns. who aspire to be hospitalists a chance to ask seasoned hospitalists about their experiences. This is what the annual meeting was all about: networking, talking with peers, and knowing that we are not alone out there practicing this new model of ob.gyn. medicine.

SOGH will hold its third annual clinical meeting in Denver from Sept. 19 to Sept. 21, 2013. Save the date to come and learn more about both the clinical and the business aspects of being an ob.gyn. hospitalist.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob/Gyn Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

What do you get when you put 83 enthusiastic ob.gyn. hospitalists, generalists, and administrators together in one big conference room in Denver? You get a lot of fun and great, relevant clinical information essential for hospitalists working all across the country today.

Even though I’ve been an ob.gyn. for 35 years and a hospitalist for the last 5, this annual clinical meeting taught me new business and clinical information. As our model of practice develops, we also can learn much from each other, and this annual event allows us to meet face-to-face to discuss our common problems, share workable solutions, and socialize.

Here were some of the meeting highlights for me:

Dr. Richard Porreco of Rocky Mountain Hospital for Children, Denver, reminded me to respect the condition of placenta percreta, and his expert advice on ways to deal with it was invaluable. He also reviewed peripartum intensive care and discussed the possible future roles for ob.gyn. hospitalists in leading critical care of these patients.

Dr. John Hobbins of the University of Colorado, Denver, explained the use of sonography in labor and delivery, an area that we will all need to pay attention to in the near future. Personally, I only use ultrasound in triage and to identify fetal position in labor, but he showed some of the benefits of using it to assist prior to operative delivery.

Darrell Ranum, J.D., regional vice president of patient safety for The Doctors Company in Columbus, Ohio, covered the factors that result in the delay in treatment of fetal heart rate abnormalities. His conclusion was that communication issues and the delay in the arrival of the physician can both be alleviated by having an ob.gyn. hospitalist on-site. This is something that we still need more data to prove, but his closed claims data was convincing.

Dr. Arthur Townsend spoke about the importance of hospitalist statistics. Collecting statistics is difficult, and hospitalists may not see the benefits. However, Dr. Townsend demonstrated how to make gathering statistics easier with his Web-based solution and the value in doing so, which we need to embrace to prove the difference we make as hospitalists.

Ob Hospitalist Group hosted the lunchtime lecture by Miranda Klassen on amniotic fluid embolism. Miranda, who founded the Amniotic Embolism Foundation (afesupport.org), is not only a survivor, she has made it her mission to educate physicians to identify and rapidly respond to this potentially fatal and often misdiagnosed condition. This was very worthwhile reviewing.

Dr. Stan Davis of Edina, Minn., spoke about the human factors in labor and delivery. He was able to communicate the TeamSTEPPS system in a concise and effective way that made it easier to understand and more relevant for me than all the other times I’ve been exposed to this complex subject.

Dr. John Nelson (nelsonflores.com), cofounder of the Society of Hospital Medicine (hospitalmedicine.org), spoke about starting and operating a professional society, and lessons learned from medical hospitalists so that, hopefully, we can avoid their early missteps.

Prior to the conference, 56 ob.gyns. participated in The Doctors Company’s highly specialized emergency obstetric simulation workshop. One of the highlights of this workshop was the attendance of Professor Christopher B. Lynch, who flew in from the United Kingdom to personally demonstrate his B-Lynch suture technique for the control of postpartum hemorrhage. In addition, GE sponsored a concurrent hands-on ultrasound in labor and delivery course with live models. It was a fantastic mix of learning and practicing old and new skills.

Questcare hosted a welcome reception, which gave attendees an informal chance to meet and discuss problems and solutions related to being hospitalists. This also gave general ob.gyns. who aspire to be hospitalists a chance to ask seasoned hospitalists about their experiences. This is what the annual meeting was all about: networking, talking with peers, and knowing that we are not alone out there practicing this new model of ob.gyn. medicine.

SOGH will hold its third annual clinical meeting in Denver from Sept. 19 to Sept. 21, 2013. Save the date to come and learn more about both the clinical and the business aspects of being an ob.gyn. hospitalist.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob/Gyn Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

When an ob.gyn. hospitalist program starts at a hospital, there is often a varying degree of distrust, resistance, and uncertainty about how hospitalists fit into the rhythm of the labor and delivery department.

In the initial stages, the ob.gyn. hospitalist may be relegated to the sidelines and just used in a limited capacity – for an emergency or for patients without a physician, for example.

In established programs, it can be the other end of the spectrum, as ob.gyn. hospitalists are looked to for oversight, leadership, and standardization, and provide these skills, often facilitating how the L&D department operates overall. They can evolve into the manager of labor and delivery rather than only providing coverage.

I was recently intrigued by an article in the New Yorker entitled,

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Big Med by Dr. Atul Gawande, a surgeon, writer, and public health researcher, in which he compares the operation of his local Cheesecake Factory restaurant to hospital medicine. He observes how, unlike in medicine, the Cheesecake Factory has figured out how to "deliver a range of services to millions of people at a reasonable cost and with a consistent level of quality." Lamenting the current state of hospital care, Dr. Gawande rightly states: "Our costs are soaring, the service is typically mediocre, and the quality is unreliable."

Dr. Gawande also points out that doctors are paid for services, not results. Unlike a restaurant, historically medicine is not service oriented. Medicine is becoming like a chain restaurant as large corporations transform it into a Southwest Airlines approach to health care – a high-quality, low-cost product.

We need to keep working toward what the Institute for Healthcare Improvement calls the

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Triple Aim, which seeks to improve the patient experience of care (including quality and satisfaction); improve the health of populations; and reduce the per capita cost of health care.

We need to demonstrate our value by continuing to emphasize our commitment to safety and quality outcomes.

It is necessary to demonstrate that our commitment to safety and quality outcomes translates into real improvement as well as real patient satisfaction. This is going to require data collection as well as new skills and competencies on our part. Not only will we have to hone our clinical skills, but we will also have to step up as leaders to work with the other members of the health care team.

How do quality and cost control occur? Is it even possible to deliver high-quality yet low-cost hospital medicine? And who is actually in charge to help make this happen?

Change in the medical world does not happen quickly; however, the adoption of ob.gyn. hospitalists is one way hospitals can immediately start addressing these issues.

Ob.gyn. hospitalists can be used in a leadership role with responsibility for a patient’s overall care, medical costs, and results. The can coordinate who cares for the patient and how, help reduce costs in malpractice by being physically present in L&D to handle emergencies or other challenging situations, oversee collaboration on standardization to deliver consistency and best practice medicine, and ensure good patient outcomes through their presence, clinical skills, and experience.

The military uses the term C4 – command, control, coordination, and communication. Adapting this for the medical environment could look something like this:

• Oversight instead of command. This can be done by facilitating how the department runs, prioritizing and assigning assets, and being the diplomat and intermediary between hospital administration and L&D.

• Leadership instead of control. This is accomplished by instituting standardization, ensuring best practices, and facilitating policy integration to enable collaboration and consensus to achieve the best possible outcomes at the lowest cost.

• Coordination. The ob.gyn. hospitalist can coordinate between patients and their family physician, midwife, or obstetrician; coordinate between the private practitioner and the ob.gyn. hospitalist; and coordinate between nurses and physicians in L&D, and the patient during follow-up.

• Communication. The ob.gyn. hospitalist can work to ensure that everyone from the L&D floor to the hospital administrators knows what is going on all of the time.

It is fascinating to watch this process occur in real time and to be part of this transformation. There are so many different variations of how ob.gyn. hospitalists are used in different programs. However, I think this gradual shift from coverage only toward oversight, leadership, coordination, and communication is inevitable. Because this transformation makes common sense and because it leads to greater patient safety with better outcomes at the same time, it reduces stress and improves working lifestyles for the private ob.gyn. as well as family physicians, midwives, and the labor and delivery nurses.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; the founding president of the Society of Ob/Gyn Hospitalists; and the founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs.

When an ob.gyn. hospitalist program starts at a hospital, there is often a varying degree of distrust, resistance, and uncertainty about how hospitalists fit into the rhythm of the labor and delivery department.

In the initial stages, the ob.gyn. hospitalist may be relegated to the sidelines and just used in a limited capacity – for an emergency or for patients without a physician, for example.

In established programs, it can be the other end of the spectrum, as ob.gyn. hospitalists are looked to for oversight, leadership, and standardization, and provide these skills, often facilitating how the L&D department operates overall. They can evolve into the manager of labor and delivery rather than only providing coverage.

I was recently intrigued by an article in the New Yorker entitled,

<cf number="\"2\"">“</cf>

<cf number="\"2\"">”</cf>

Big Med by Dr. Atul Gawande, a surgeon, writer, and public health researcher, in which he compares the operation of his local Cheesecake Factory restaurant to hospital medicine. He observes how, unlike in medicine, the Cheesecake Factory has figured out how to "deliver a range of services to millions of people at a reasonable cost and with a consistent level of quality." Lamenting the current state of hospital care, Dr. Gawande rightly states: "Our costs are soaring, the service is typically mediocre, and the quality is unreliable."

Dr. Gawande also points out that doctors are paid for services, not results. Unlike a restaurant, historically medicine is not service oriented. Medicine is becoming like a chain restaurant as large corporations transform it into a Southwest Airlines approach to health care – a high-quality, low-cost product.

We need to keep working toward what the Institute for Healthcare Improvement calls the

<cf number="\"2\"">“</cf>

<cf number="\"2\"">”</cf>

Triple Aim, which seeks to improve the patient experience of care (including quality and satisfaction); improve the health of populations; and reduce the per capita cost of health care.

We need to demonstrate our value by continuing to emphasize our commitment to safety and quality outcomes.

It is necessary to demonstrate that our commitment to safety and quality outcomes translates into real improvement as well as real patient satisfaction. This is going to require data collection as well as new skills and competencies on our part. Not only will we have to hone our clinical skills, but we will also have to step up as leaders to work with the other members of the health care team.

How do quality and cost control occur? Is it even possible to deliver high-quality yet low-cost hospital medicine? And who is actually in charge to help make this happen?

Change in the medical world does not happen quickly; however, the adoption of ob.gyn. hospitalists is one way hospitals can immediately start addressing these issues.

Ob.gyn. hospitalists can be used in a leadership role with responsibility for a patient’s overall care, medical costs, and results. The can coordinate who cares for the patient and how, help reduce costs in malpractice by being physically present in L&D to handle emergencies or other challenging situations, oversee collaboration on standardization to deliver consistency and best practice medicine, and ensure good patient outcomes through their presence, clinical skills, and experience.

The military uses the term C4 – command, control, coordination, and communication. Adapting this for the medical environment could look something like this:

• Oversight instead of command. This can be done by facilitating how the department runs, prioritizing and assigning assets, and being the diplomat and intermediary between hospital administration and L&D.

• Leadership instead of control. This is accomplished by instituting standardization, ensuring best practices, and facilitating policy integration to enable collaboration and consensus to achieve the best possible outcomes at the lowest cost.

• Coordination. The ob.gyn. hospitalist can coordinate between patients and their family physician, midwife, or obstetrician; coordinate between the private practitioner and the ob.gyn. hospitalist; and coordinate between nurses and physicians in L&D, and the patient during follow-up.

• Communication. The ob.gyn. hospitalist can work to ensure that everyone from the L&D floor to the hospital administrators knows what is going on all of the time.

It is fascinating to watch this process occur in real time and to be part of this transformation. There are so many different variations of how ob.gyn. hospitalists are used in different programs. However, I think this gradual shift from coverage only toward oversight, leadership, coordination, and communication is inevitable. Because this transformation makes common sense and because it leads to greater patient safety with better outcomes at the same time, it reduces stress and improves working lifestyles for the private ob.gyn. as well as family physicians, midwives, and the labor and delivery nurses.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; the founding president of the Society of Ob/Gyn Hospitalists; and the founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs.

When an ob.gyn. hospitalist program starts at a hospital, there is often a varying degree of distrust, resistance, and uncertainty about how hospitalists fit into the rhythm of the labor and delivery department.

In the initial stages, the ob.gyn. hospitalist may be relegated to the sidelines and just used in a limited capacity – for an emergency or for patients without a physician, for example.

In established programs, it can be the other end of the spectrum, as ob.gyn. hospitalists are looked to for oversight, leadership, and standardization, and provide these skills, often facilitating how the L&D department operates overall. They can evolve into the manager of labor and delivery rather than only providing coverage.

I was recently intrigued by an article in the New Yorker entitled,

<cf number="\"2\"">“</cf>

<cf number="\"2\"">”</cf>

Big Med by Dr. Atul Gawande, a surgeon, writer, and public health researcher, in which he compares the operation of his local Cheesecake Factory restaurant to hospital medicine. He observes how, unlike in medicine, the Cheesecake Factory has figured out how to "deliver a range of services to millions of people at a reasonable cost and with a consistent level of quality." Lamenting the current state of hospital care, Dr. Gawande rightly states: "Our costs are soaring, the service is typically mediocre, and the quality is unreliable."

Dr. Gawande also points out that doctors are paid for services, not results. Unlike a restaurant, historically medicine is not service oriented. Medicine is becoming like a chain restaurant as large corporations transform it into a Southwest Airlines approach to health care – a high-quality, low-cost product.

We need to keep working toward what the Institute for Healthcare Improvement calls the

<cf number="\"2\"">“</cf>

<cf number="\"2\"">”</cf>

Triple Aim, which seeks to improve the patient experience of care (including quality and satisfaction); improve the health of populations; and reduce the per capita cost of health care.

We need to demonstrate our value by continuing to emphasize our commitment to safety and quality outcomes.

It is necessary to demonstrate that our commitment to safety and quality outcomes translates into real improvement as well as real patient satisfaction. This is going to require data collection as well as new skills and competencies on our part. Not only will we have to hone our clinical skills, but we will also have to step up as leaders to work with the other members of the health care team.

How do quality and cost control occur? Is it even possible to deliver high-quality yet low-cost hospital medicine? And who is actually in charge to help make this happen?

Change in the medical world does not happen quickly; however, the adoption of ob.gyn. hospitalists is one way hospitals can immediately start addressing these issues.

Ob.gyn. hospitalists can be used in a leadership role with responsibility for a patient’s overall care, medical costs, and results. The can coordinate who cares for the patient and how, help reduce costs in malpractice by being physically present in L&D to handle emergencies or other challenging situations, oversee collaboration on standardization to deliver consistency and best practice medicine, and ensure good patient outcomes through their presence, clinical skills, and experience.

The military uses the term C4 – command, control, coordination, and communication. Adapting this for the medical environment could look something like this:

• Oversight instead of command. This can be done by facilitating how the department runs, prioritizing and assigning assets, and being the diplomat and intermediary between hospital administration and L&D.

• Leadership instead of control. This is accomplished by instituting standardization, ensuring best practices, and facilitating policy integration to enable collaboration and consensus to achieve the best possible outcomes at the lowest cost.

• Coordination. The ob.gyn. hospitalist can coordinate between patients and their family physician, midwife, or obstetrician; coordinate between the private practitioner and the ob.gyn. hospitalist; and coordinate between nurses and physicians in L&D, and the patient during follow-up.

• Communication. The ob.gyn. hospitalist can work to ensure that everyone from the L&D floor to the hospital administrators knows what is going on all of the time.

It is fascinating to watch this process occur in real time and to be part of this transformation. There are so many different variations of how ob.gyn. hospitalists are used in different programs. However, I think this gradual shift from coverage only toward oversight, leadership, coordination, and communication is inevitable. Because this transformation makes common sense and because it leads to greater patient safety with better outcomes at the same time, it reduces stress and improves working lifestyles for the private ob.gyn. as well as family physicians, midwives, and the labor and delivery nurses.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; the founding president of the Society of Ob/Gyn Hospitalists; and the founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs.

Through my experience as an ob.gyn. hospitalist, it quickly became clear which things work well and which things do not in an ob.gyn. hospitalist program.

Although internal medicine and pediatrics have been using the hospitalist model for quite some time, it is still a model in its infancy for ob.gyn. medicine. With hospitals investing significant amounts of funding to start ob.gyn. hospitalist programs, there is neither time nor money to waste on pursuing the things that don’t work. The expectation is that even though it’s a new program, it should work almost immediately.

Those who have been through the torturous process of establishing, integrating, and/or converting to any new program in any aspect of life know that this is a fairly unrealistic expectation. There are, however, some basic ingredients or attributes that I believe must be present to lessen the pain and increase an ob.gyn. hospitalist program’s chances of success.

The following are some qualities that should be considered when ob.gyn. hospitalist candidates are interviewed:

• A physician who is a seasoned professional. Finding and then hiring the right people are always challenges in any industry, but even more so for ob.gyn. hospitalist recruitment. The best candidates for ob.gyn. hospitalist jobs need to be seasoned board-certified physicians. Not only will they be involved in every true ob.gyn. emergency, but they must also be able to educate and hold their ground against other, sometimes older ob.gyns., family physicians, and midwives who may not be practicing the most up-to-date, evidence-based medicine. This is not a job for a beginner. Physicians with expert clinical skills are essential for a program’s success, as they are the first responders and must be able to deal with or assist in every situation that presents itself.

• A physician who is a team player. The team needs to be flexible and responsible. Smooth handoff rounds, conveying all necessary information, are essential. An outgoing physician needs to introduce the incoming physician to any active patients. Scheduling needs to be fair and allow call dates to be traded to fit everyone’s schedule. Obviously, team members won’t know if they will be compatible until they start working together, but hospitalists must be willing to leave their egos at the door to be "team players."

• A doctor who is willing to serve. The private practitioner obstetrician needs to keep her own patient happy and safe, whereas ob.gyn. hospitalists need to keep all the patients and all the labor and delivery professionals (and sometimes the gynecology emergency department professionals) safe and happy. Ob.gyn. hospitalists need to go out of their way to ask nurses and physicians the question: Is there anything I can do to help?

One of the great things about being a hospitalist is that the work is so varied, but programs need hospitalists who are willing to help anyone who asks and are comfortable doing so – from the private practitioner who needs a quick ultrasound to determine position, to the OR tech who requires help moving a patient. Some physicians may think these tasks are just scut work, but they are essential to developing a safe, efficient high-reliability organization (HRO) that can avoid catastrophe in a real crisis or emergency.

• A physician who inspires trust. Hospitalists are consistently meeting patients for the first time. They won’t have developed a relationship with patients over the previous months of pregnancy, so ob.gyn. hospitalists need to be able to bond with them and their families quickly. For example, one of the tools I find to be effective when I deal with a mom who has experienced a failed home birth by a lay midwife is this simple phrase: "I know this is not what you planned, but I am so glad that you are here with us so we can take care of you."

• A doctor who is a good communicator. Hospitalists need to be able to solve problems quickly by using tact, diplomacy, and professionalism at all times. Being involved with emergencies and bad outcomes, they need to be comfortable with debriefing the team and communicating sensitively with patients and families. Highly developed communication skills also extend to documenting the chart and liaising with an absent private practitioner, the nursing team, and the hospital’s administration.

I was one of the original ob.gyn. hospitalists at my community hospital in Bellingham, Wash. Having Dr. Chris Swain’s company, the OB Hospitalist Group, consult helped us to quickly establish a successful new program. Our team of four hospitalists is employed by St. Joseph’s Medical Center. It is a successful program that I’m proud to say encompasses these aforementioned ingredients: We smoothly integrate our scheduling and handoffs; the local obstetricians, family practitioners, and midwives trust us and appreciate our work; and we regularly foster open communication by attending the nurses’ handoff meetings as well as huddling with the anesthesiologist and nurse team leader.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

Through my experience as an ob.gyn. hospitalist, it quickly became clear which things work well and which things do not in an ob.gyn. hospitalist program.

Although internal medicine and pediatrics have been using the hospitalist model for quite some time, it is still a model in its infancy for ob.gyn. medicine. With hospitals investing significant amounts of funding to start ob.gyn. hospitalist programs, there is neither time nor money to waste on pursuing the things that don’t work. The expectation is that even though it’s a new program, it should work almost immediately.

Those who have been through the torturous process of establishing, integrating, and/or converting to any new program in any aspect of life know that this is a fairly unrealistic expectation. There are, however, some basic ingredients or attributes that I believe must be present to lessen the pain and increase an ob.gyn. hospitalist program’s chances of success.

The following are some qualities that should be considered when ob.gyn. hospitalist candidates are interviewed:

• A physician who is a seasoned professional. Finding and then hiring the right people are always challenges in any industry, but even more so for ob.gyn. hospitalist recruitment. The best candidates for ob.gyn. hospitalist jobs need to be seasoned board-certified physicians. Not only will they be involved in every true ob.gyn. emergency, but they must also be able to educate and hold their ground against other, sometimes older ob.gyns., family physicians, and midwives who may not be practicing the most up-to-date, evidence-based medicine. This is not a job for a beginner. Physicians with expert clinical skills are essential for a program’s success, as they are the first responders and must be able to deal with or assist in every situation that presents itself.

• A physician who is a team player. The team needs to be flexible and responsible. Smooth handoff rounds, conveying all necessary information, are essential. An outgoing physician needs to introduce the incoming physician to any active patients. Scheduling needs to be fair and allow call dates to be traded to fit everyone’s schedule. Obviously, team members won’t know if they will be compatible until they start working together, but hospitalists must be willing to leave their egos at the door to be "team players."

• A doctor who is willing to serve. The private practitioner obstetrician needs to keep her own patient happy and safe, whereas ob.gyn. hospitalists need to keep all the patients and all the labor and delivery professionals (and sometimes the gynecology emergency department professionals) safe and happy. Ob.gyn. hospitalists need to go out of their way to ask nurses and physicians the question: Is there anything I can do to help?

One of the great things about being a hospitalist is that the work is so varied, but programs need hospitalists who are willing to help anyone who asks and are comfortable doing so – from the private practitioner who needs a quick ultrasound to determine position, to the OR tech who requires help moving a patient. Some physicians may think these tasks are just scut work, but they are essential to developing a safe, efficient high-reliability organization (HRO) that can avoid catastrophe in a real crisis or emergency.

• A physician who inspires trust. Hospitalists are consistently meeting patients for the first time. They won’t have developed a relationship with patients over the previous months of pregnancy, so ob.gyn. hospitalists need to be able to bond with them and their families quickly. For example, one of the tools I find to be effective when I deal with a mom who has experienced a failed home birth by a lay midwife is this simple phrase: "I know this is not what you planned, but I am so glad that you are here with us so we can take care of you."

• A doctor who is a good communicator. Hospitalists need to be able to solve problems quickly by using tact, diplomacy, and professionalism at all times. Being involved with emergencies and bad outcomes, they need to be comfortable with debriefing the team and communicating sensitively with patients and families. Highly developed communication skills also extend to documenting the chart and liaising with an absent private practitioner, the nursing team, and the hospital’s administration.

I was one of the original ob.gyn. hospitalists at my community hospital in Bellingham, Wash. Having Dr. Chris Swain’s company, the OB Hospitalist Group, consult helped us to quickly establish a successful new program. Our team of four hospitalists is employed by St. Joseph’s Medical Center. It is a successful program that I’m proud to say encompasses these aforementioned ingredients: We smoothly integrate our scheduling and handoffs; the local obstetricians, family practitioners, and midwives trust us and appreciate our work; and we regularly foster open communication by attending the nurses’ handoff meetings as well as huddling with the anesthesiologist and nurse team leader.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

Through my experience as an ob.gyn. hospitalist, it quickly became clear which things work well and which things do not in an ob.gyn. hospitalist program.

Although internal medicine and pediatrics have been using the hospitalist model for quite some time, it is still a model in its infancy for ob.gyn. medicine. With hospitals investing significant amounts of funding to start ob.gyn. hospitalist programs, there is neither time nor money to waste on pursuing the things that don’t work. The expectation is that even though it’s a new program, it should work almost immediately.

Those who have been through the torturous process of establishing, integrating, and/or converting to any new program in any aspect of life know that this is a fairly unrealistic expectation. There are, however, some basic ingredients or attributes that I believe must be present to lessen the pain and increase an ob.gyn. hospitalist program’s chances of success.

The following are some qualities that should be considered when ob.gyn. hospitalist candidates are interviewed:

• A physician who is a seasoned professional. Finding and then hiring the right people are always challenges in any industry, but even more so for ob.gyn. hospitalist recruitment. The best candidates for ob.gyn. hospitalist jobs need to be seasoned board-certified physicians. Not only will they be involved in every true ob.gyn. emergency, but they must also be able to educate and hold their ground against other, sometimes older ob.gyns., family physicians, and midwives who may not be practicing the most up-to-date, evidence-based medicine. This is not a job for a beginner. Physicians with expert clinical skills are essential for a program’s success, as they are the first responders and must be able to deal with or assist in every situation that presents itself.

• A physician who is a team player. The team needs to be flexible and responsible. Smooth handoff rounds, conveying all necessary information, are essential. An outgoing physician needs to introduce the incoming physician to any active patients. Scheduling needs to be fair and allow call dates to be traded to fit everyone’s schedule. Obviously, team members won’t know if they will be compatible until they start working together, but hospitalists must be willing to leave their egos at the door to be "team players."

• A doctor who is willing to serve. The private practitioner obstetrician needs to keep her own patient happy and safe, whereas ob.gyn. hospitalists need to keep all the patients and all the labor and delivery professionals (and sometimes the gynecology emergency department professionals) safe and happy. Ob.gyn. hospitalists need to go out of their way to ask nurses and physicians the question: Is there anything I can do to help?

One of the great things about being a hospitalist is that the work is so varied, but programs need hospitalists who are willing to help anyone who asks and are comfortable doing so – from the private practitioner who needs a quick ultrasound to determine position, to the OR tech who requires help moving a patient. Some physicians may think these tasks are just scut work, but they are essential to developing a safe, efficient high-reliability organization (HRO) that can avoid catastrophe in a real crisis or emergency.

• A physician who inspires trust. Hospitalists are consistently meeting patients for the first time. They won’t have developed a relationship with patients over the previous months of pregnancy, so ob.gyn. hospitalists need to be able to bond with them and their families quickly. For example, one of the tools I find to be effective when I deal with a mom who has experienced a failed home birth by a lay midwife is this simple phrase: "I know this is not what you planned, but I am so glad that you are here with us so we can take care of you."

• A doctor who is a good communicator. Hospitalists need to be able to solve problems quickly by using tact, diplomacy, and professionalism at all times. Being involved with emergencies and bad outcomes, they need to be comfortable with debriefing the team and communicating sensitively with patients and families. Highly developed communication skills also extend to documenting the chart and liaising with an absent private practitioner, the nursing team, and the hospital’s administration.

I was one of the original ob.gyn. hospitalists at my community hospital in Bellingham, Wash. Having Dr. Chris Swain’s company, the OB Hospitalist Group, consult helped us to quickly establish a successful new program. Our team of four hospitalists is employed by St. Joseph’s Medical Center. It is a successful program that I’m proud to say encompasses these aforementioned ingredients: We smoothly integrate our scheduling and handoffs; the local obstetricians, family practitioners, and midwives trust us and appreciate our work; and we regularly foster open communication by attending the nurses’ handoff meetings as well as huddling with the anesthesiologist and nurse team leader.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash.; founding president of the Society of Ob.Gyn. Hospitalists; and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs. E-mail Dr. Olson at obnews@elsevier.com.

Did you know that the Society of OB/GYN Hospitalists is holding its second annual clinical meeting on Sept. 27-29, 2012, in Denver? Did you know that the Society of OB/GYN Hospitalists (SOGH) even existed? With more than 100 paid founding members, SOGH is not yet widely known within the ob.gyn. community; however, it did not emerge overnight.

Formally established in 2011, it came about due to a group of like-minded and dedicated ob.gyn. hospitalist volunteers who, like me, wanted to create a formal community that would address our specific needs, answer our particular questions, and reinforce, bolster and support our emerging position of influence in ob.gyn. hospital care.

With the concept of the "ob.gyn. hospitalist" widely embraced only since 2003, I wasn’t sure how many other physicians were practicing this model of ob.gyn. care. I was certain I wasn’t alone, so in 2008 I launched my website ObGynHospitalist.com to make sure. It was a fairly "homemade" effort at first, but approximately 175 ob.gyn. hospitalists of varying descriptions joined my site in its first 2 years. I had gathered together a community of disconnected, somewhat frustrated, and often isolated hospitalists who were motivated to connect and exchange answers with one another.

As the number of members grew, and the website became the only professional resource for ob.gyn. hospitalists, there was increasing interest in getting together in person. In 2010, I requested that the American College of Obstetricians and Gynecologists (ACOG) allow us to hold a Special Interest Group meeting at its annual clinical meeting (ACM) in San Francisco. I was thrilled that more than 75 people showed up and a lively discussion of hospitalist-specific issues clearly showed that there was a need for a more formal organization to be formed.

An organizational meeting was held in Denver in October 2010 with 17 people in attendance. A pivotal moment at that meeting was when Dr. Larry Wellikson, the Society of Hospital Medicine’s CEO, gave us invaluable advice on how to form a nonprofit medical society.

A second Special Interest Group meeting was held at the 2011 ACOG ACM in Washington, D.C. This provided the impetus and the volunteers to start organizing the society’s first ACM. In September 2011, it all came together. With 43 enthusiastic ob.gyn. hospitalists, generalists, and administrators in attendance, SOGH was officially born.

Cochaired by Dr. Karenmarie Meyer and myself, the conference covered a range of important clinical and business issues that affect ob.gyn. hospitalists. Presentations included best practices in obstetric triage and evidence-based cesarean section techniques. Data collection techniques, safety and malpractice issues, and ob.gyn. hospitalists’ core competencies also were discussed. The SOGH board of directors was elected. Volunteers signed up for four separate committees, and committee chairs were elected.

Following the ACM, The Doctors Company conducted a first-of-its-kind Obstetrical Emergency Simulation Workshop. One of the highlights was the attendance of Prof. Christopher B. Lynch, who flew in from the United Kingdom to personally demonstrate his B-Lynch suture. He will again be in attendance for the simulation workshop on Sept. 27, 2012.

Last month SOGH achieved another milestone with the launch of its website SocietyofOBGYNHospitalists.com, which is where you can find this year’s ACM schedule and registration form, as well as SOGH membership applications.

As SOGH’s outgoing founding president, I’m proud to have overseen its inception, birth, recognition as a nonprofit 503(c)3* organization, and the preparation for the second ACM. Dr. Meyer takes over as president after the ACM, and I look forward to watching it mature in the years to come.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash., the founding president of the Society of Ob/Gyn Hospitalists, and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs.

* Correction made 8/20/2012

Did you know that the Society of OB/GYN Hospitalists is holding its second annual clinical meeting on Sept. 27-29, 2012, in Denver? Did you know that the Society of OB/GYN Hospitalists (SOGH) even existed? With more than 100 paid founding members, SOGH is not yet widely known within the ob.gyn. community; however, it did not emerge overnight.

Formally established in 2011, it came about due to a group of like-minded and dedicated ob.gyn. hospitalist volunteers who, like me, wanted to create a formal community that would address our specific needs, answer our particular questions, and reinforce, bolster and support our emerging position of influence in ob.gyn. hospital care.

With the concept of the "ob.gyn. hospitalist" widely embraced only since 2003, I wasn’t sure how many other physicians were practicing this model of ob.gyn. care. I was certain I wasn’t alone, so in 2008 I launched my website ObGynHospitalist.com to make sure. It was a fairly "homemade" effort at first, but approximately 175 ob.gyn. hospitalists of varying descriptions joined my site in its first 2 years. I had gathered together a community of disconnected, somewhat frustrated, and often isolated hospitalists who were motivated to connect and exchange answers with one another.

As the number of members grew, and the website became the only professional resource for ob.gyn. hospitalists, there was increasing interest in getting together in person. In 2010, I requested that the American College of Obstetricians and Gynecologists (ACOG) allow us to hold a Special Interest Group meeting at its annual clinical meeting (ACM) in San Francisco. I was thrilled that more than 75 people showed up and a lively discussion of hospitalist-specific issues clearly showed that there was a need for a more formal organization to be formed.

An organizational meeting was held in Denver in October 2010 with 17 people in attendance. A pivotal moment at that meeting was when Dr. Larry Wellikson, the Society of Hospital Medicine’s CEO, gave us invaluable advice on how to form a nonprofit medical society.

A second Special Interest Group meeting was held at the 2011 ACOG ACM in Washington, D.C. This provided the impetus and the volunteers to start organizing the society’s first ACM. In September 2011, it all came together. With 43 enthusiastic ob.gyn. hospitalists, generalists, and administrators in attendance, SOGH was officially born.

Cochaired by Dr. Karenmarie Meyer and myself, the conference covered a range of important clinical and business issues that affect ob.gyn. hospitalists. Presentations included best practices in obstetric triage and evidence-based cesarean section techniques. Data collection techniques, safety and malpractice issues, and ob.gyn. hospitalists’ core competencies also were discussed. The SOGH board of directors was elected. Volunteers signed up for four separate committees, and committee chairs were elected.

Following the ACM, The Doctors Company conducted a first-of-its-kind Obstetrical Emergency Simulation Workshop. One of the highlights was the attendance of Prof. Christopher B. Lynch, who flew in from the United Kingdom to personally demonstrate his B-Lynch suture. He will again be in attendance for the simulation workshop on Sept. 27, 2012.

Last month SOGH achieved another milestone with the launch of its website SocietyofOBGYNHospitalists.com, which is where you can find this year’s ACM schedule and registration form, as well as SOGH membership applications.

As SOGH’s outgoing founding president, I’m proud to have overseen its inception, birth, recognition as a nonprofit 503(c)3* organization, and the preparation for the second ACM. Dr. Meyer takes over as president after the ACM, and I look forward to watching it mature in the years to come.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash., the founding president of the Society of Ob/Gyn Hospitalists, and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs.

* Correction made 8/20/2012

Did you know that the Society of OB/GYN Hospitalists is holding its second annual clinical meeting on Sept. 27-29, 2012, in Denver? Did you know that the Society of OB/GYN Hospitalists (SOGH) even existed? With more than 100 paid founding members, SOGH is not yet widely known within the ob.gyn. community; however, it did not emerge overnight.

Formally established in 2011, it came about due to a group of like-minded and dedicated ob.gyn. hospitalist volunteers who, like me, wanted to create a formal community that would address our specific needs, answer our particular questions, and reinforce, bolster and support our emerging position of influence in ob.gyn. hospital care.

With the concept of the "ob.gyn. hospitalist" widely embraced only since 2003, I wasn’t sure how many other physicians were practicing this model of ob.gyn. care. I was certain I wasn’t alone, so in 2008 I launched my website ObGynHospitalist.com to make sure. It was a fairly "homemade" effort at first, but approximately 175 ob.gyn. hospitalists of varying descriptions joined my site in its first 2 years. I had gathered together a community of disconnected, somewhat frustrated, and often isolated hospitalists who were motivated to connect and exchange answers with one another.

As the number of members grew, and the website became the only professional resource for ob.gyn. hospitalists, there was increasing interest in getting together in person. In 2010, I requested that the American College of Obstetricians and Gynecologists (ACOG) allow us to hold a Special Interest Group meeting at its annual clinical meeting (ACM) in San Francisco. I was thrilled that more than 75 people showed up and a lively discussion of hospitalist-specific issues clearly showed that there was a need for a more formal organization to be formed.

An organizational meeting was held in Denver in October 2010 with 17 people in attendance. A pivotal moment at that meeting was when Dr. Larry Wellikson, the Society of Hospital Medicine’s CEO, gave us invaluable advice on how to form a nonprofit medical society.

A second Special Interest Group meeting was held at the 2011 ACOG ACM in Washington, D.C. This provided the impetus and the volunteers to start organizing the society’s first ACM. In September 2011, it all came together. With 43 enthusiastic ob.gyn. hospitalists, generalists, and administrators in attendance, SOGH was officially born.

Cochaired by Dr. Karenmarie Meyer and myself, the conference covered a range of important clinical and business issues that affect ob.gyn. hospitalists. Presentations included best practices in obstetric triage and evidence-based cesarean section techniques. Data collection techniques, safety and malpractice issues, and ob.gyn. hospitalists’ core competencies also were discussed. The SOGH board of directors was elected. Volunteers signed up for four separate committees, and committee chairs were elected.

Following the ACM, The Doctors Company conducted a first-of-its-kind Obstetrical Emergency Simulation Workshop. One of the highlights was the attendance of Prof. Christopher B. Lynch, who flew in from the United Kingdom to personally demonstrate his B-Lynch suture. He will again be in attendance for the simulation workshop on Sept. 27, 2012.

Last month SOGH achieved another milestone with the launch of its website SocietyofOBGYNHospitalists.com, which is where you can find this year’s ACM schedule and registration form, as well as SOGH membership applications.

As SOGH’s outgoing founding president, I’m proud to have overseen its inception, birth, recognition as a nonprofit 503(c)3* organization, and the preparation for the second ACM. Dr. Meyer takes over as president after the ACM, and I look forward to watching it mature in the years to come.

Dr. Olson is an ob.gyn. hospitalist in Bellingham, Wash., the founding president of the Society of Ob/Gyn Hospitalists, and founder of www.obgynhospitalist.com. He is a consultant for ob.gyn. hospitalist programs.

* Correction made 8/20/2012