With over 80,000 babies delivered and more than 1,200 lives saved in the last year, it’s hard to imagine OB/GYN care today without OB hospitalists. In just two decades, Ob Hospitalist Group (OBHG) has grown from an idea to a fully integrated model of care in states across the country.

When OB/GYN hospitalist medicine first emerged, many private physicians viewed it as a stopgap solution. Like internal medicine hospitalists, OB hospitalists serve as extra hands to cover unassigned patients or step in during an emergency. Today, OB hospitalists and OB Emergency Departments (OBED) are transforming obstetric care, reshaping patient safety, improving clinician well-being and increasing access to high-quality maternal services in nearly every state.

The evolution of OB hospitalists is best understood through the voices of clinicians working in it. In a recent webinar, Susan Smith, MD, Vice President of Clinician Success, and David Vallejo, MD, Market Medical Director, reflect on how far OB hospitalist medicine has come and where the field is headed.

Click here to watch the full webinar.

One physician’s vision improves national care

Christopher Swain, MD, founder of OBHG, had an epiphany while sparring over couch lounge space on a night shift at a Sarasota, Florida hospital. Why were multiple physicians losing sleep doing work that could be managed by one?

Meanwhile, pregnant patients with emergencies were seeing a nurse who would relay information to a physician off-site, who was woken in the night.

“He recognized the importance of having a person in the hospital around the clock to provide care to those triage patients and intervene in emergencies, as well as provide support to private physicians,” says Dr. Smith.

Dr. Swain launched OBHG in 2006, testing the concept of an OBED. Four OB hospitalists delivered 15 babies in Florida that year. The program has grown exponentially ever since. Today, there are over 300 programs across 42 states with over 2,000 dedicated clinicians.

Finding a career-long calling

Dr. Smith joined OBHG in 2011 and didn’t expect to stay. She was transitioning out of a demanding academic medicine position and imagined the hospitalist role as a bridge.

“I came, I saw, and I stayed. I fell in love with the mission and with being able to focus on inpatient care,” she says.

Like many OB/GYNs, her heart was always on labor and delivery. As a hospitalist, roughly 85% of her daily work remained in obstetrics, returning her to the part of medicine she loved most.

Dr. Vallejo’s path was equally rooted in the need for balance. Both he and his wife are OB/GYNs. With two young kids, they struggled to keep up with unpredictable hours.

“One of us needed to do something different, so when OBHG approached me, I took a leap of faith. I never turned back.”

Today, he says, “I love every day that I’m on.” Their experience mirrors that of their over 2,000 colleagues at OBHG.

A more equitable model

From the start, hospitalists played a crucial role in leveling the playing field for maternal care. Dr. Smith, who began her hospitalist career in a community with a large migrant population, sees this firsthand.

“Those patients didn’t always receive the same level of care as private patients. Being able to standardize care and be immediately available for emergencies is deeply fulfilling.”

OBHG data confirms the impact. Across OBHG programs, clinicians:

• Are sued 75% less often than private OB/GYNs
• Achieve a 30% reduction in severe perinatal morbidity
• Deliver equitable outcomes for minority patients, outperforming national CDC benchmarks

Hospitalists care for the highest-risk patients, such as those with no prenatal care, no records, or late presentation, yet still have a dramatically lower malpractice exposure.

“Because our doctors aren’t constrained by any time pressures themselves, we have improved NTSV rates, improved quality and morbidity mortality response times. Our black and brown moms have as good an outcome as any other race of moms,” says Dr. Smith.

The reason is simple: real-time presence.

“You can’t be dinged for a delay in care when there is no delay in care,” says Dr. Smith.

A life saved in minutes: Why presence matters

OB hospitalists save lives so regularly that it’s simply a part of their daily work. Still, everyone has stories they’ll never forget that underscore the need for immediate, on-unit physician coverage. For Dr. Smith, one of those stories began when a patient arrived at 37.5 weeks, two prior C-sections, abdominal pain and a reactive NST. The contractions spaced out with hydration, so nothing was outwardly alarming. Still, something felt off.

“I couldn’t put my finger on it, but I was uncomfortable,” says Dr. Smith.

An hour later, the fetal heart tones vanished from the monitor. With no in-house anesthesia and no time to wait, Dr. Smith moved the patient to the OR and performed a stat C-section under local anesthesia. The baby was free-floating in the abdomen with a cord pH of 6.95.

“We saved that baby’s life before anesthesia even arrived. That’s the power of having someone physically in the hospital who can act immediately,” she says.

Becoming essential members of the care team

While OB hospitalists began as outsiders to community OBs, that perception has flipped today.

“We’re an integral part of the care team of every patient on labor and delivery because we are there,” says Dr. Vallejo.

Hospitalists perform tasks that keep private OBs from having to rush to the hospital, including: amniotomies, internal monitors, second opinions on tracings, operative deliveries for midwives and rapid response to emergencies. In many markets, hospitalists have become the inpatient service arm for private practices, FQHCs and family medicine residencies.

“We’re used as a marketing tool to attract physicians to the hospital, knowing that there’s someone always there ready to take care of their patients if something happens,” says Dr. Vallejo.

OB hospitalists also serve as:

• Department chairs
• Quality and safety committee leaders
• Champions for simulation drills
• Partners to nurse educators
• Mentors to new CNMs, residents and early-career physicians

Why OB hospitalist programs are growing so quickly

Several forces continue to accelerate the adoption of OB hospitalist programs nationwide since OBHG was founded.

A changing physician workforce

As younger physicians seek greater work-life balance and older physicians are slowing down in their careers, OB without fully retiring, hospitalists are positioned to support both.

Hospitalists are an antidote to burnout

For OB/GYNs seeking a way to stay in a field they love without burning out, working a few shifts a month as an OB hospitalist offers the work/life balance many seek. There are no phone calls, no charts to do at home and no overnight shifts on call. “When you’re on, you’re on, and when you’re off, you’re off,” says Dr. Vallejo.

A career as an OB hospitalist means:

• Safer doctors
• More present parents
• Longer careers
• Better patient outcomes

Coverage for communities

OB hospitalists support community doctors by providing trusted colleagues to take care of their patients when they can’t be there. They also provide crucial care for those who don’t have prenatal care from a private physician. Across the country, 86% of our hospital partners report improved satisfaction among their community physicians after partnering with OBHG.

OBHG hospitalists:

• Manage unassigned patients
• Provide 24/7 coverage
• Support midwives
• Back up family medicine residents
• Serve as the delivery arm for FQHCs

Hospitalists as safety champions

OB hospitalists improve safety, not only by being present 24/7, but also by elevating care across the department. Increasingly, OB hospitalists lead department-wide safety efforts, including:

• Postpartum hemorrhage protocols
• Hypertensive emergency management
• Simulation drills and debriefings
• Review and revision of L&D policies
• Multidisciplinary rounds

From nurses to community physicians, everyone on the floor today relies heavily on hospitalists for real-time guidance and support.

“Gone are the days when a hospitalist waits to be called,” says Dr. Smith.

This culture shift is improving outcomes across entire hospitals, not just for hospitalist-managed patients.

Future of the field

As OB/GYN needs evolve in the United States, so does the role of the OB hospitalist. One of the most promising trends is telehealth for MFMs, Obtelecare. In rural settings, the nearest specialist may be hours away. Telehealth allows maternal fetal medicine hospitalists to offer real-time guidance on complex cases, closing a gap that puts women at risk.

“Having the availability to consult an MFM is going to really be a game changer, expanding care to our rural hospital settings and elevating the standard of care for these women,” says Dr. Vallejo.

For example, in OBHG’s first teleMFM program in Summerville, South Carolina, a patient in a rural area was able to conveniently access care for her high-risk pregnancy without having to continuously drive long distances to an academic medical center. When the tele-MFM identified a fetal cardiac anomaly at the time of her delivery, the patient was transferred to a tertiary center to deliver with a pediatric cardiologist on standby.

“Having the right person at the right time and at the right place makes tele-MFM a total game changer for patient care,” says Dr. Smith.

Hospital leaders are also watching the impending OB/GYN shortage. As demand grows and staffing thins, the hospitalist model offers a sustainable, scalable solution.

A model that’s here to stay

OB/GYN hospitalist medicine has evolved from an innovative idea to a mainstay of modern obstetric care. Today, having an OB hospitalist program is:

• Safer for patients
• Supportive for community clinicians
• Efficient for hospitals
• Attractive for physician recruitment
• Equitable for underserved communities

For OB/GYNs, the hospitalist model keeps them in a job they love, says Dr. Smith.

“It really allows the best of both worlds—the ability to practice medicine and do what we love, while also being present and doing what gives us personal satisfaction and growth. We love delivering babies. Hospitalist medicine lets us do what we love and live the lives we want. It’s the best of both worlds.”

And as maternal health challenges grow nationwide, OB hospitalists are increasingly the steady presence that ensures every woman receives timely, expert, compassionate care—no matter when she walks through the door.

Contact our recruiting department for more information on current openings and how to join us in making a difference in women’s healthcare.