Ob/gyn Andrew Vincent doesn't wear a beeper. When he's off work, he's really off, spending uninterrupted time with his three kids.
That's unusual for someone in his specialty, but then Vincent works exclusively inside Legacy Salmon Creek Hospital in Vancouver, WA, pulling seven or eight 24-hour shifts per month. The biggest part of his job is delivering the babies of uninsured women who appear in the emergency department without having received prenatal care. Less commonly, he delivers the babies of patients under the care of an office-based ob/gyn who's tied up in traffic or catching a baby at another hospital.
A growing number of hospitals are hiring a new breed of ob/gyns such as Vincent who are called laborists or ob/gyn hospitalists. Resembling hospitalists drawn from the ranks of internal medicine, these clinicians are at a patient's bedside in a jiffy. This onsite presence is critical in obstetrics, when a baby in fetal distress demands immediate action. Besides improving patient care, a laborist can lower a hospital's malpractice liability and insurance premiums, says Louis Weinstein, ob/gyn department chair at Thomas Jefferson University Hospital in Philadelphia.
Laborists reap rewards, too—predictable schedules, relief from running a practice, and competitive compensation. And with hospitals paying for malpractice coverage, ob/gyns driven from obstetrics by sky-high premiums find it feasible once more to deliver babies.
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