Rob Olson, MD

It is a sad fact that not only are there are more and more high-risk pregnancies, but there are not enough maternal-fetal medicine physicians to help care for them.

Some fellowship programs are emphasizing outpatient consultation and ultrasound rather than the critical care of the high-risk inpatient. There are not enough perinatologists to treat the growing number of elderly mothers and diabetics or to handle the increase in obese, hypertensive, and multiple gestation pregnancies.

Additionally, just like everyone else, maternal-fetal medicine physicians (MFMs) have the pressure of being in two places at once: the office and the hospital. Small group or solo practices feel this strain even more, and many times limit their practice to outpatient consultation only.

As most of us in the hospital trenches know, this MFM shortage can create the perfect storm for a very bad outcome. However, ob.gyn. hospitalists can step into this void.

In January 2012, ObGynHospitalist.com conducted the first survey to find out how ob.gyn. hospitalists and MFMs are working together. It revealed that more than 70% of ob.gyn. hospitalists work with high-risk patients, and the vast majority work with private-practice or hospital-employed MFM specialists, most often on a daily basis.

Another significant finding from the survey was that the majority of ob.gyn. hospitalist programs do not or rarely share patients with the local MFM(s). In the one-third of programs that always or mostly share patients, the ob.gyn. hospitalist is the assigned admitting physician half the time, a MFM is the assigned admitting physician 14% of the time, and 38% stated that it could be either.

Most shared patients are seen by either an ob.gyn. hospitalist or MFM(s). Ob.gyn. hospitalists perform floor rounds on shared patients 23% of the time, round together with a MFM(s) 12% of the time, and MFMs exclusively make floor rounds on only 10% of shared patients. Separate rounds are performed 24% of the time.

This partnership that is created between the MFM and the ob.gyn. hospitalist means that hospitalists can be MFM extenders, and high-risk patients can be given more immediate attention.

I was recruited by Dr. Reinaldo Acosta, a solo MFM who could only do outpatient consults and couldn’t take call until he started an ob.gyn. hospitalist program in Spokane, Wash., in 2007. The results were tremendous. The hospitalist took care of his inpatients, he could take call because he rarely had to come in at night, and he was usually not disturbed in the office. He was covered for vacations and several weekends a month by a locum, Dr. Jorge Talosa. Over 4 years, neonatal intensive care unit bed occupation numbers increased from 8,302 to 15,625, and Dr. Acosta created new sources of revenue for the hospital by increasing transports of very sick mothers and preterm deliveries. It also allowed the hospital to have both better safety and quality of service, because a board-certified ob.gyn. was present 24/7 to handle emergencies and support the private ob.gyns. and family practitioners.

This new model, where general ob.gyns. act as perinatology extenders, benefits everyone. It also addresses the shortage of MFMs as well as the increasing number of high-risk patients. As ob.gyn. hospitalists develop their clinical obstetric skills and experience, they may complement MFMs as the primary caregiver to high-risk women in the hospital. It will be interesting to see how this develops. Will the 4-year general ob.gyn. residency change? Will there be a special fellowship in ob.gyn. hospital medicine? Will there be a separate board certification?

Ob.gyn. hospitalists want to – and should – have a closer working relationship with their local MFMs. This isn’t just to increase and find new revenue for hospitals; it can benefit all obstetric patients, ob.gyn. hospitalists, and MFMs, as well as community obstetricians and the hospital’s obstetric service, too. The ObGynHospitalist.com survey results lend legitimacy to the relationship, but it’s up to the stakeholders to forge closer ties and adopt this new partnership model to improve high-risk patient care.

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.

It is a sad fact that not only are there are more and more high-risk pregnancies, but there are not enough maternal-fetal medicine physicians to help care for them.

Some fellowship programs are emphasizing outpatient consultation and ultrasound rather than the critical care of the high-risk inpatient. There are not enough perinatologists to treat the growing number of elderly mothers and diabetics or to handle the increase in obese, hypertensive, and multiple gestation pregnancies.

Additionally, just like everyone else, maternal-fetal medicine physicians (MFMs) have the pressure of being in two places at once: the office and the hospital. Small group or solo practices feel this strain even more, and many times limit their practice to outpatient consultation only.

As most of us in the hospital trenches know, this MFM shortage can create the perfect storm for a very bad outcome. However, ob.gyn. hospitalists can step into this void.

In January 2012, ObGynHospitalist.com conducted the first survey to find out how ob.gyn. hospitalists and MFMs are working together. It revealed that more than 70% of ob.gyn. hospitalists work with high-risk patients, and the vast majority work with private-practice or hospital-employed MFM specialists, most often on a daily basis.

Another significant finding from the survey was that the majority of ob.gyn. hospitalist programs do not or rarely share patients with the local MFM(s). In the one-third of programs that always or mostly share patients, the ob.gyn. hospitalist is the assigned admitting physician half the time, a MFM is the assigned admitting physician 14% of the time, and 38% stated that it could be either.

Most shared patients are seen by either an ob.gyn. hospitalist or MFM(s). Ob.gyn. hospitalists perform floor rounds on shared patients 23% of the time, round together with a MFM(s) 12% of the time, and MFMs exclusively make floor rounds on only 10% of shared patients. Separate rounds are performed 24% of the time.

This partnership that is created between the MFM and the ob.gyn. hospitalist means that hospitalists can be MFM extenders, and high-risk patients can be given more immediate attention.

I was recruited by Dr. Reinaldo Acosta, a solo MFM who could only do outpatient consults and couldn’t take call until he started an ob.gyn. hospitalist program in Spokane, Wash., in 2007. The results were tremendous. The hospitalist took care of his inpatients, he could take call because he rarely had to come in at night, and he was usually not disturbed in the office. He was covered for vacations and several weekends a month by a locum, Dr. Jorge Talosa. Over 4 years, neonatal intensive care unit bed occupation numbers increased from 8,302 to 15,625, and Dr. Acosta created new sources of revenue for the hospital by increasing transports of very sick mothers and preterm deliveries. It also allowed the hospital to have both better safety and quality of service, because a board-certified ob.gyn. was present 24/7 to handle emergencies and support the private ob.gyns. and family practitioners.

This new model, where general ob.gyns. act as perinatology extenders, benefits everyone. It also addresses the shortage of MFMs as well as the increasing number of high-risk patients. As ob.gyn. hospitalists develop their clinical obstetric skills and experience, they may complement MFMs as the primary caregiver to high-risk women in the hospital. It will be interesting to see how this develops. Will the 4-year general ob.gyn. residency change? Will there be a special fellowship in ob.gyn. hospital medicine? Will there be a separate board certification?

Ob.gyn. hospitalists want to – and should – have a closer working relationship with their local MFMs. This isn’t just to increase and find new revenue for hospitals; it can benefit all obstetric patients, ob.gyn. hospitalists, and MFMs, as well as community obstetricians and the hospital’s obstetric service, too. The ObGynHospitalist.com survey results lend legitimacy to the relationship, but it’s up to the stakeholders to forge closer ties and adopt this new partnership model to improve high-risk patient care.

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.

It is a sad fact that not only are there are more and more high-risk pregnancies, but there are not enough maternal-fetal medicine physicians to help care for them.

Some fellowship programs are emphasizing outpatient consultation and ultrasound rather than the critical care of the high-risk inpatient. There are not enough perinatologists to treat the growing number of elderly mothers and diabetics or to handle the increase in obese, hypertensive, and multiple gestation pregnancies.

Additionally, just like everyone else, maternal-fetal medicine physicians (MFMs) have the pressure of being in two places at once: the office and the hospital. Small group or solo practices feel this strain even more, and many times limit their practice to outpatient consultation only.

As most of us in the hospital trenches know, this MFM shortage can create the perfect storm for a very bad outcome. However, ob.gyn. hospitalists can step into this void.

In January 2012, ObGynHospitalist.com conducted the first survey to find out how ob.gyn. hospitalists and MFMs are working together. It revealed that more than 70% of ob.gyn. hospitalists work with high-risk patients, and the vast majority work with private-practice or hospital-employed MFM specialists, most often on a daily basis.

Another significant finding from the survey was that the majority of ob.gyn. hospitalist programs do not or rarely share patients with the local MFM(s). In the one-third of programs that always or mostly share patients, the ob.gyn. hospitalist is the assigned admitting physician half the time, a MFM is the assigned admitting physician 14% of the time, and 38% stated that it could be either.

Most shared patients are seen by either an ob.gyn. hospitalist or MFM(s). Ob.gyn. hospitalists perform floor rounds on shared patients 23% of the time, round together with a MFM(s) 12% of the time, and MFMs exclusively make floor rounds on only 10% of shared patients. Separate rounds are performed 24% of the time.

This partnership that is created between the MFM and the ob.gyn. hospitalist means that hospitalists can be MFM extenders, and high-risk patients can be given more immediate attention.

I was recruited by Dr. Reinaldo Acosta, a solo MFM who could only do outpatient consults and couldn’t take call until he started an ob.gyn. hospitalist program in Spokane, Wash., in 2007. The results were tremendous. The hospitalist took care of his inpatients, he could take call because he rarely had to come in at night, and he was usually not disturbed in the office. He was covered for vacations and several weekends a month by a locum, Dr. Jorge Talosa. Over 4 years, neonatal intensive care unit bed occupation numbers increased from 8,302 to 15,625, and Dr. Acosta created new sources of revenue for the hospital by increasing transports of very sick mothers and preterm deliveries. It also allowed the hospital to have both better safety and quality of service, because a board-certified ob.gyn. was present 24/7 to handle emergencies and support the private ob.gyns. and family practitioners.

This new model, where general ob.gyns. act as perinatology extenders, benefits everyone. It also addresses the shortage of MFMs as well as the increasing number of high-risk patients. As ob.gyn. hospitalists develop their clinical obstetric skills and experience, they may complement MFMs as the primary caregiver to high-risk women in the hospital. It will be interesting to see how this develops. Will the 4-year general ob.gyn. residency change? Will there be a special fellowship in ob.gyn. hospital medicine? Will there be a separate board certification?

Ob.gyn. hospitalists want to – and should – have a closer working relationship with their local MFMs. This isn’t just to increase and find new revenue for hospitals; it can benefit all obstetric patients, ob.gyn. hospitalists, and MFMs, as well as community obstetricians and the hospital’s obstetric service, too. The ObGynHospitalist.com survey results lend legitimacy to the relationship, but it’s up to the stakeholders to forge closer ties and adopt this new partnership model to improve high-risk patient care.

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.

Soon after I became an ob.gyn. hospitalist, I became one of its biggest and most vocal proponents. I started a website, ObGynHospitalist.com, set about learning and educating myself, and eventually became a consultant on establishing different ob.gyn. hospitalist programs around the country.

Through this experience, it quickly became clear which things worked well and which things did not. It also became immediately obvious that every hospital has different needs and problems, and every hospital needs a tailor-made ob.gyn. hospitalist. Fortunately, the hospitalist model is flexible and can adapt to each unique hospital setting.

In a fledgling subspecialty, with hospital corporations investing significant amounts of funding to start ob.gyn. hospitalist programs, there isn’t time (or money) to waste on pursuing the things that didn’t work. It is expected that, even though it’s a new program, it should work well almost immediately. Increased safety, better outcomes, and the elimination of unattended deliveries are immediate results when a program is implemented. What take longer to demonstrate are the benefits to the private obstetricians. But 3-6 months after a program starts, they become ob.gyn. hospitalists’ biggest supporters.

There are some basic ingredients I believe must be present in order to lessen the pain of implementing a new ob.gyn. hospitalist program and increase its chances of success.

Qualifications

Hiring the right people is always a challenge – in any industry. It can be even more so for ob.gyn. hospitalist recruitment. The standard is high: The ideal candidate must not only be board certified, but also a seasoned physician who can handle every true emergency, perform difficult operative deliveries, and counsel, advise, and teach older ob.gyns., family physicians, and midwives who may not be practicing up-to-date evidence-based medicine. This is not a job for a rookie.

Team Players

The team has to be compatible, flexible, and responsible – and egos must be left at the front door. Communication is vital: Smooth handoff rounds conveying all the necessary information are essential. The hospitalist also must have a personality that enables him or her to quickly bond with all patients and their families after handover. Additionally, scheduling needs to be fair and allow call dates to be traded to fit everyone’s schedule.

Service Orientation

Not only do the physicians need to keep their teammates and patients happy, they need to keep everyone happy. They need to look at systemwide improvements, listen to concerns, implement standardized protocols, and always encourage best practices. This is where customer service is imperative, and ob.gyn. hospitalists must go out of their way to ask nurses, staff, and physicians the question: "Is there anything I can do to help?"

Hospital Administration Support

Like all other internal medicine and pediatric hospitalist programs, ob.gyn. hospitalist programs need to be subsidized. It takes approximately $1.3-$1.7 million to start a program, and after a year, it is probably only bringing in about $1 million. The financial investment is worth it to the hospital because it results in better outcomes that lead to lower malpractice costs, as well as happier private physicians. Higher satisfaction in labor and delivery helps with recruitment and retention of nurses and physicians alike. It is also a marketable, competitive advantage that the hospital can use to attract more patients.

Whatever form a local ob.gyn. hospitalist program takes, these four common factors are essential to its foundation. The program must be flexible enough to meet unique local needs while still adhering to proven elements that ensure success.

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. Email Dr. Olson at obnews@elsevier.com.

Soon after I became an ob.gyn. hospitalist, I became one of its biggest and most vocal proponents. I started a website, ObGynHospitalist.com, set about learning and educating myself, and eventually became a consultant on establishing different ob.gyn. hospitalist programs around the country.

Through this experience, it quickly became clear which things worked well and which things did not. It also became immediately obvious that every hospital has different needs and problems, and every hospital needs a tailor-made ob.gyn. hospitalist. Fortunately, the hospitalist model is flexible and can adapt to each unique hospital setting.

In a fledgling subspecialty, with hospital corporations investing significant amounts of funding to start ob.gyn. hospitalist programs, there isn’t time (or money) to waste on pursuing the things that didn’t work. It is expected that, even though it’s a new program, it should work well almost immediately. Increased safety, better outcomes, and the elimination of unattended deliveries are immediate results when a program is implemented. What take longer to demonstrate are the benefits to the private obstetricians. But 3-6 months after a program starts, they become ob.gyn. hospitalists’ biggest supporters.

There are some basic ingredients I believe must be present in order to lessen the pain of implementing a new ob.gyn. hospitalist program and increase its chances of success.

Qualifications

Hiring the right people is always a challenge – in any industry. It can be even more so for ob.gyn. hospitalist recruitment. The standard is high: The ideal candidate must not only be board certified, but also a seasoned physician who can handle every true emergency, perform difficult operative deliveries, and counsel, advise, and teach older ob.gyns., family physicians, and midwives who may not be practicing up-to-date evidence-based medicine. This is not a job for a rookie.

Team Players

The team has to be compatible, flexible, and responsible – and egos must be left at the front door. Communication is vital: Smooth handoff rounds conveying all the necessary information are essential. The hospitalist also must have a personality that enables him or her to quickly bond with all patients and their families after handover. Additionally, scheduling needs to be fair and allow call dates to be traded to fit everyone’s schedule.

Service Orientation

Not only do the physicians need to keep their teammates and patients happy, they need to keep everyone happy. They need to look at systemwide improvements, listen to concerns, implement standardized protocols, and always encourage best practices. This is where customer service is imperative, and ob.gyn. hospitalists must go out of their way to ask nurses, staff, and physicians the question: "Is there anything I can do to help?"

Hospital Administration Support

Like all other internal medicine and pediatric hospitalist programs, ob.gyn. hospitalist programs need to be subsidized. It takes approximately $1.3-$1.7 million to start a program, and after a year, it is probably only bringing in about $1 million. The financial investment is worth it to the hospital because it results in better outcomes that lead to lower malpractice costs, as well as happier private physicians. Higher satisfaction in labor and delivery helps with recruitment and retention of nurses and physicians alike. It is also a marketable, competitive advantage that the hospital can use to attract more patients.

Whatever form a local ob.gyn. hospitalist program takes, these four common factors are essential to its foundation. The program must be flexible enough to meet unique local needs while still adhering to proven elements that ensure success.

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. Email Dr. Olson at obnews@elsevier.com.

Soon after I became an ob.gyn. hospitalist, I became one of its biggest and most vocal proponents. I started a website, ObGynHospitalist.com, set about learning and educating myself, and eventually became a consultant on establishing different ob.gyn. hospitalist programs around the country.

Through this experience, it quickly became clear which things worked well and which things did not. It also became immediately obvious that every hospital has different needs and problems, and every hospital needs a tailor-made ob.gyn. hospitalist. Fortunately, the hospitalist model is flexible and can adapt to each unique hospital setting.

In a fledgling subspecialty, with hospital corporations investing significant amounts of funding to start ob.gyn. hospitalist programs, there isn’t time (or money) to waste on pursuing the things that didn’t work. It is expected that, even though it’s a new program, it should work well almost immediately. Increased safety, better outcomes, and the elimination of unattended deliveries are immediate results when a program is implemented. What take longer to demonstrate are the benefits to the private obstetricians. But 3-6 months after a program starts, they become ob.gyn. hospitalists’ biggest supporters.

There are some basic ingredients I believe must be present in order to lessen the pain of implementing a new ob.gyn. hospitalist program and increase its chances of success.

Qualifications

Hiring the right people is always a challenge – in any industry. It can be even more so for ob.gyn. hospitalist recruitment. The standard is high: The ideal candidate must not only be board certified, but also a seasoned physician who can handle every true emergency, perform difficult operative deliveries, and counsel, advise, and teach older ob.gyns., family physicians, and midwives who may not be practicing up-to-date evidence-based medicine. This is not a job for a rookie.

Team Players

The team has to be compatible, flexible, and responsible – and egos must be left at the front door. Communication is vital: Smooth handoff rounds conveying all the necessary information are essential. The hospitalist also must have a personality that enables him or her to quickly bond with all patients and their families after handover. Additionally, scheduling needs to be fair and allow call dates to be traded to fit everyone’s schedule.

Service Orientation

Not only do the physicians need to keep their teammates and patients happy, they need to keep everyone happy. They need to look at systemwide improvements, listen to concerns, implement standardized protocols, and always encourage best practices. This is where customer service is imperative, and ob.gyn. hospitalists must go out of their way to ask nurses, staff, and physicians the question: "Is there anything I can do to help?"

Hospital Administration Support

Like all other internal medicine and pediatric hospitalist programs, ob.gyn. hospitalist programs need to be subsidized. It takes approximately $1.3-$1.7 million to start a program, and after a year, it is probably only bringing in about $1 million. The financial investment is worth it to the hospital because it results in better outcomes that lead to lower malpractice costs, as well as happier private physicians. Higher satisfaction in labor and delivery helps with recruitment and retention of nurses and physicians alike. It is also a marketable, competitive advantage that the hospital can use to attract more patients.

Whatever form a local ob.gyn. hospitalist program takes, these four common factors are essential to its foundation. The program must be flexible enough to meet unique local needs while still adhering to proven elements that ensure success.

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. Email Dr. Olson at obnews@elsevier.com.

I love my job.

"Choose a job you love, and you will never have to work a day in your life." – Confucius

Everyone knows this Confucius quote. Its overuse makes it sound cheesy, unrealistic, and it’s dubious that a Chinese philosopher who died in 479 BC could still be relevant in today’s fast-paced modern world. I am, however, now a believer because I love my job and it doesn’t feel like work. Honestly.

I enjoyed having a solo general ob.gyn. practice and reveled in its multidimensional challenges: running an office, being able to choose my own great staff, developing long-term rewarding relationships with my patients, and doing complex gynecologic surgeries. However, after 28 years, I heard Dr. Lou Weinstein give the first lecture I was aware of at the American College of Obstetricians and Gynecologists Annual Clinical meeting in 2005 about ob.gyn. hospitalists. I returned home and put my practice up for sale.

I wanted to use my array of skills outside a traditional office setting and reduce my stress levels. To find that elusive work/life balance and influence best practices in obstetric medicine, I needed to find a job that I loved, not merely enjoyed.

Five years ago, I found a second career in which I could do all these things, truly specialize in obstetrics, and hone my clinical skills into a defined purpose: improving patient care and safety. I became an ob.gyn. hospitalist.

Prior to becoming an ob.gyn. hospitalist, my biggest frustration at my private practice was that I constantly had to be in two or three places at once. Balancing this physical impossibility among laboring patients, keeping office appointments, and being required in surgery was my greatest source of stress. Today, my attention is focused solely on labor and delivery (L&D). My hospital doesn’t require me cover to emergency department gynecology, which I believe is safer for the patients because, without additional gynecological responsibilities, I am not overextended and can focus all my energy exactly where it is needed. It is safer for women in labor to have me physically present in L&D rather than be in the ER, or worse, in the operating room.

Safety is what drives the whole ob.gyn. hospitalist movement. It is gratifying to see all of the reports of patients "saved" because of the presence of an ob.gyn. hospitalist. (Become a registered ObGynHospitalist.com member to see more than 40 examples of "saves and "near misses" in the Discussion forum under the Clinical Issues tab). We are working on collecting data to prove this, and the Society of Ob/Gyn Hospitalists (SOGH) has a dedicated Research, Education, and Safety Committee to document what we already anecdotally know.

One of my first "saves" as an ob.gyn. hospitalist came about when a family practitioner was attempting to deliver a baby at 2 a.m. and encountered a severe shoulder dystocia he couldn’t resolve. By the time I arrived in the delivery room, it had already been between 2 and 3 minutes. I was fortunate to be able to step in and complete the delivery without harm to either the mother or infant. In contrast, if an on-call obstetrician had been summoned from home, there may have been a very different outcome.

The combination of experience, skills, and, most importantly, my presence in L&D created a positive outcome. This is another reason I love my job: I can truly make an immediate difference just by being there. And that’s not work.

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.

I love my job.

"Choose a job you love, and you will never have to work a day in your life." – Confucius

Everyone knows this Confucius quote. Its overuse makes it sound cheesy, unrealistic, and it’s dubious that a Chinese philosopher who died in 479 BC could still be relevant in today’s fast-paced modern world. I am, however, now a believer because I love my job and it doesn’t feel like work. Honestly.

I enjoyed having a solo general ob.gyn. practice and reveled in its multidimensional challenges: running an office, being able to choose my own great staff, developing long-term rewarding relationships with my patients, and doing complex gynecologic surgeries. However, after 28 years, I heard Dr. Lou Weinstein give the first lecture I was aware of at the American College of Obstetricians and Gynecologists Annual Clinical meeting in 2005 about ob.gyn. hospitalists. I returned home and put my practice up for sale.

I wanted to use my array of skills outside a traditional office setting and reduce my stress levels. To find that elusive work/life balance and influence best practices in obstetric medicine, I needed to find a job that I loved, not merely enjoyed.

Five years ago, I found a second career in which I could do all these things, truly specialize in obstetrics, and hone my clinical skills into a defined purpose: improving patient care and safety. I became an ob.gyn. hospitalist.

Prior to becoming an ob.gyn. hospitalist, my biggest frustration at my private practice was that I constantly had to be in two or three places at once. Balancing this physical impossibility among laboring patients, keeping office appointments, and being required in surgery was my greatest source of stress. Today, my attention is focused solely on labor and delivery (L&D). My hospital doesn’t require me cover to emergency department gynecology, which I believe is safer for the patients because, without additional gynecological responsibilities, I am not overextended and can focus all my energy exactly where it is needed. It is safer for women in labor to have me physically present in L&D rather than be in the ER, or worse, in the operating room.

Safety is what drives the whole ob.gyn. hospitalist movement. It is gratifying to see all of the reports of patients "saved" because of the presence of an ob.gyn. hospitalist. (Become a registered ObGynHospitalist.com member to see more than 40 examples of "saves and "near misses" in the Discussion forum under the Clinical Issues tab). We are working on collecting data to prove this, and the Society of Ob/Gyn Hospitalists (SOGH) has a dedicated Research, Education, and Safety Committee to document what we already anecdotally know.

One of my first "saves" as an ob.gyn. hospitalist came about when a family practitioner was attempting to deliver a baby at 2 a.m. and encountered a severe shoulder dystocia he couldn’t resolve. By the time I arrived in the delivery room, it had already been between 2 and 3 minutes. I was fortunate to be able to step in and complete the delivery without harm to either the mother or infant. In contrast, if an on-call obstetrician had been summoned from home, there may have been a very different outcome.

The combination of experience, skills, and, most importantly, my presence in L&D created a positive outcome. This is another reason I love my job: I can truly make an immediate difference just by being there. And that’s not work.

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.

I love my job.

"Choose a job you love, and you will never have to work a day in your life." – Confucius

Everyone knows this Confucius quote. Its overuse makes it sound cheesy, unrealistic, and it’s dubious that a Chinese philosopher who died in 479 BC could still be relevant in today’s fast-paced modern world. I am, however, now a believer because I love my job and it doesn’t feel like work. Honestly.

I enjoyed having a solo general ob.gyn. practice and reveled in its multidimensional challenges: running an office, being able to choose my own great staff, developing long-term rewarding relationships with my patients, and doing complex gynecologic surgeries. However, after 28 years, I heard Dr. Lou Weinstein give the first lecture I was aware of at the American College of Obstetricians and Gynecologists Annual Clinical meeting in 2005 about ob.gyn. hospitalists. I returned home and put my practice up for sale.

I wanted to use my array of skills outside a traditional office setting and reduce my stress levels. To find that elusive work/life balance and influence best practices in obstetric medicine, I needed to find a job that I loved, not merely enjoyed.

Five years ago, I found a second career in which I could do all these things, truly specialize in obstetrics, and hone my clinical skills into a defined purpose: improving patient care and safety. I became an ob.gyn. hospitalist.

Prior to becoming an ob.gyn. hospitalist, my biggest frustration at my private practice was that I constantly had to be in two or three places at once. Balancing this physical impossibility among laboring patients, keeping office appointments, and being required in surgery was my greatest source of stress. Today, my attention is focused solely on labor and delivery (L&D). My hospital doesn’t require me cover to emergency department gynecology, which I believe is safer for the patients because, without additional gynecological responsibilities, I am not overextended and can focus all my energy exactly where it is needed. It is safer for women in labor to have me physically present in L&D rather than be in the ER, or worse, in the operating room.

Safety is what drives the whole ob.gyn. hospitalist movement. It is gratifying to see all of the reports of patients "saved" because of the presence of an ob.gyn. hospitalist. (Become a registered ObGynHospitalist.com member to see more than 40 examples of "saves and "near misses" in the Discussion forum under the Clinical Issues tab). We are working on collecting data to prove this, and the Society of Ob/Gyn Hospitalists (SOGH) has a dedicated Research, Education, and Safety Committee to document what we already anecdotally know.

One of my first "saves" as an ob.gyn. hospitalist came about when a family practitioner was attempting to deliver a baby at 2 a.m. and encountered a severe shoulder dystocia he couldn’t resolve. By the time I arrived in the delivery room, it had already been between 2 and 3 minutes. I was fortunate to be able to step in and complete the delivery without harm to either the mother or infant. In contrast, if an on-call obstetrician had been summoned from home, there may have been a very different outcome.

The combination of experience, skills, and, most importantly, my presence in L&D created a positive outcome. This is another reason I love my job: I can truly make an immediate difference just by being there. And that’s not work.

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.

The term "hospitalist" is commonly thought of as an internist or pediatrician model. However, in 2003, Dr. Louis Weinstein, professor and former chair of obstetrics and gynecology at Thomas Jefferson University Hospital, Philadelphia, proposed the idea of hospital-based obstetricians primarily to improve patient safety.

While there are various evolving models for what type of care an ob.gyn. hospitalist provides, he or she is generally considered to be a board-certified ob.gyn. who is physically present in the hospital, primarily in labor and delivery, although some programs require coverage of gynecology in the emergency room.

The ob.gyn. hospitalist is there for safety: They cover triage, labor, delivery, and postpartum care for all unassigned patients, as well as for those patients signed out to them by a private practitioner. They commonly assist at cesarean sections, respond to almost all true emergencies, and do consults and operative deliveries for family practitioners and midwives. Frequently, they are asked to stand by for deliveries while the private practitioner makes their way in from home or the office. On request, they also perform procedures such as artificial rupture of members (AROM), bedside ultrasound for position, and insertion of pressure transducer catheters.

While it may be obvious, there is evidence-based data which proves that hospitals with ob.gyn. hospitalists have an increased level of safety, which directly leads to a decrease in bad outcomes and subsequent medical malpractice costs. An excellent example is that an ob.gyn. hospitalist can begin a cesarean section for a prolapsed cord before a private practitioner can be there. When they do arrive, the private practitioner can take over the surgery, and the hospitalist can assist as required or requested.

In addition to clinical work, hospitalists teach, run simulations, and are leaders in implementing systemwide changes that increase patient safety, quality, outcomes, satisfaction, teamwork, and overall departmental improvements. They reduce the problems of fragmented care, may work as perinatology extenders, and are immediately available for any situation that arises.

There also are other unintended benefits of ob.gyn. hospitalists. Clinical decision waiting time is reduced, communication is increased, nurses can obtain immediate evaluations and recommendations, and hospital administrators can use them as a tool for marketing to patients as well as recruiting and retaining physicians and nurses.

Ob.gyn. hospitalists also facilitate an improved personal-professional lifestyle balance for general ob.gyns. and family physicians. Ob.gyn. hospitalists allow them to stay in the office or surgery when needed or sign out patients when fatigued or when they simply wish to take a vacation.

I have been an ob.gyn. hospitalist since leaving my solo general ob.gyn. practice in 2007. At that time, I could only identify 10-12 programs within an emerging ob.gyn. hospitalist subspecialty. Now there are over 150 programs across the United States, with one to two new programs emerging each month. My website, ObGynHospitalist.com, was established to provide a professional resource for ob.gyn. hospitalists, where over 800 registered members can access new opportunities, and a forum to exchange ideas and discuss all aspects of our fledgling subspecialty.

In September 2011, the nonprofit Society of Ob/Gyn Hospitalists (SOGH) was established. It now has over 60 paid members, and I am honored to be its founding president.

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 term "hospitalist" is commonly thought of as an internist or pediatrician model. However, in 2003, Dr. Louis Weinstein, professor and former chair of obstetrics and gynecology at Thomas Jefferson University Hospital, Philadelphia, proposed the idea of hospital-based obstetricians primarily to improve patient safety.

While there are various evolving models for what type of care an ob.gyn. hospitalist provides, he or she is generally considered to be a board-certified ob.gyn. who is physically present in the hospital, primarily in labor and delivery, although some programs require coverage of gynecology in the emergency room.

The ob.gyn. hospitalist is there for safety: They cover triage, labor, delivery, and postpartum care for all unassigned patients, as well as for those patients signed out to them by a private practitioner. They commonly assist at cesarean sections, respond to almost all true emergencies, and do consults and operative deliveries for family practitioners and midwives. Frequently, they are asked to stand by for deliveries while the private practitioner makes their way in from home or the office. On request, they also perform procedures such as artificial rupture of members (AROM), bedside ultrasound for position, and insertion of pressure transducer catheters.

While it may be obvious, there is evidence-based data which proves that hospitals with ob.gyn. hospitalists have an increased level of safety, which directly leads to a decrease in bad outcomes and subsequent medical malpractice costs. An excellent example is that an ob.gyn. hospitalist can begin a cesarean section for a prolapsed cord before a private practitioner can be there. When they do arrive, the private practitioner can take over the surgery, and the hospitalist can assist as required or requested.

In addition to clinical work, hospitalists teach, run simulations, and are leaders in implementing systemwide changes that increase patient safety, quality, outcomes, satisfaction, teamwork, and overall departmental improvements. They reduce the problems of fragmented care, may work as perinatology extenders, and are immediately available for any situation that arises.

There also are other unintended benefits of ob.gyn. hospitalists. Clinical decision waiting time is reduced, communication is increased, nurses can obtain immediate evaluations and recommendations, and hospital administrators can use them as a tool for marketing to patients as well as recruiting and retaining physicians and nurses.

Ob.gyn. hospitalists also facilitate an improved personal-professional lifestyle balance for general ob.gyns. and family physicians. Ob.gyn. hospitalists allow them to stay in the office or surgery when needed or sign out patients when fatigued or when they simply wish to take a vacation.

I have been an ob.gyn. hospitalist since leaving my solo general ob.gyn. practice in 2007. At that time, I could only identify 10-12 programs within an emerging ob.gyn. hospitalist subspecialty. Now there are over 150 programs across the United States, with one to two new programs emerging each month. My website, ObGynHospitalist.com, was established to provide a professional resource for ob.gyn. hospitalists, where over 800 registered members can access new opportunities, and a forum to exchange ideas and discuss all aspects of our fledgling subspecialty.

In September 2011, the nonprofit Society of Ob/Gyn Hospitalists (SOGH) was established. It now has over 60 paid members, and I am honored to be its founding president.

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 term "hospitalist" is commonly thought of as an internist or pediatrician model. However, in 2003, Dr. Louis Weinstein, professor and former chair of obstetrics and gynecology at Thomas Jefferson University Hospital, Philadelphia, proposed the idea of hospital-based obstetricians primarily to improve patient safety.

While there are various evolving models for what type of care an ob.gyn. hospitalist provides, he or she is generally considered to be a board-certified ob.gyn. who is physically present in the hospital, primarily in labor and delivery, although some programs require coverage of gynecology in the emergency room.

The ob.gyn. hospitalist is there for safety: They cover triage, labor, delivery, and postpartum care for all unassigned patients, as well as for those patients signed out to them by a private practitioner. They commonly assist at cesarean sections, respond to almost all true emergencies, and do consults and operative deliveries for family practitioners and midwives. Frequently, they are asked to stand by for deliveries while the private practitioner makes their way in from home or the office. On request, they also perform procedures such as artificial rupture of members (AROM), bedside ultrasound for position, and insertion of pressure transducer catheters.

While it may be obvious, there is evidence-based data which proves that hospitals with ob.gyn. hospitalists have an increased level of safety, which directly leads to a decrease in bad outcomes and subsequent medical malpractice costs. An excellent example is that an ob.gyn. hospitalist can begin a cesarean section for a prolapsed cord before a private practitioner can be there. When they do arrive, the private practitioner can take over the surgery, and the hospitalist can assist as required or requested.

In addition to clinical work, hospitalists teach, run simulations, and are leaders in implementing systemwide changes that increase patient safety, quality, outcomes, satisfaction, teamwork, and overall departmental improvements. They reduce the problems of fragmented care, may work as perinatology extenders, and are immediately available for any situation that arises.

There also are other unintended benefits of ob.gyn. hospitalists. Clinical decision waiting time is reduced, communication is increased, nurses can obtain immediate evaluations and recommendations, and hospital administrators can use them as a tool for marketing to patients as well as recruiting and retaining physicians and nurses.

Ob.gyn. hospitalists also facilitate an improved personal-professional lifestyle balance for general ob.gyns. and family physicians. Ob.gyn. hospitalists allow them to stay in the office or surgery when needed or sign out patients when fatigued or when they simply wish to take a vacation.

I have been an ob.gyn. hospitalist since leaving my solo general ob.gyn. practice in 2007. At that time, I could only identify 10-12 programs within an emerging ob.gyn. hospitalist subspecialty. Now there are over 150 programs across the United States, with one to two new programs emerging each month. My website, ObGynHospitalist.com, was established to provide a professional resource for ob.gyn. hospitalists, where over 800 registered members can access new opportunities, and a forum to exchange ideas and discuss all aspects of our fledgling subspecialty.

In September 2011, the nonprofit Society of Ob/Gyn Hospitalists (SOGH) was established. It now has over 60 paid members, and I am honored to be its founding president.

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.