Selected Podcast

The Evolution of OB Hospitalist Medicine

With growing pressures on hospitals to address maternal mortality and implement standard labor and delivery protocols, today's OB hospitalist role is expanding. Not only are OB hospitalists providing 24/7 care and partnering with community physicians, but they are also evolving to become maternal safety champions of the entire labor and delivery unit.
The Evolution of OB Hospitalist Medicine
Featured Speaker:
Mark Simon, MD
Boasting extensive experience in medical management through a variety of physician leadership roles, Dr. Simon is a Board Certified OB/GYN. He joined Ob Hospitalist Group in January 2009 as a full-time OB/GYN hospitalist at Valley Medical Center in Renton, Washington, where he served as Chief of the Department of Obstetrics and Gynecology for four years.

Dr. Simon graduated summa cum laude with a BA in economics from the University of Colorado and earned his medical degree from Eastern Virginia Medical School in Norfolk, Virginia, graduating Alpha Omega Alpha. He completed residency training at Exempla St. Joseph Hospital in Denver, Colorado, and has since received his Master’s in medical management degree from Carnegie Mellon University in Pittsburgh, Pennsylvania.
Transcription:

Prakash Chandran: As the nation's largest and only dedicated OB-GYN hospitalist provider, OB hospitalist group is a recognized leader in elevating the quality and safety of women's healthcare. Their vision is to elevate the standard of women's healthcare by delivering specialized services that improve quality and positively impact the lives of women, their newborns and the families they serve.

Today, we'll be discussing the evolution of OB Hospitalist Medicine with Dr. Mark Simon. He's the Chief Medical Officer at OB Hospitalist Group.

This is the Obstetrics Podcast from OB Hospitalist Group. My name is Prakash Chandran. So Dr. Simon, thank you so much for being here today. We really appreciate your time. I'd love to get started by asking, when did you first get involved with OB hospitalist medicine? And how are you connected with OB hospitalist medicine today?

Dr Mark Simon: Yeah. Great to be here as well. I got involved with OB hospitalist medicine when I became an OB hospitalist clinical provider, clinical physician in early 2009. And since then, I've remained in OB hospitalist medicine with OB Hospitalist Group and, as you mentioned earlier, served as the chief medical officer for OB Hospitalist Group today.

Prakash Chandran: Okay. So 2009, almost 15 years ago. I'm curious if OB hospitalist medicine was a common career path for OB-GYNs at that time.

Dr Mark Simon: I would not say it was common at all. I would say back 15 years ago, people would typically pursue either fellowship training in one of the fellowships or just general OB-GYN career pathway, which involves, you know, traditional OB-GYN practice, outpatient, inpatient, and surgeries and things of that nature. So pretty uncommon for people to choose to be a dedicated OB hospitalist as a career.

Prakash Chandran: Yeah, I can understand that. So at that time, what exactly was the scope of practice for OB hospitalists?

Dr Mark Simon: Usually, OB hospitalists we're brought in mostly as a safety factor. So they're in the hospital to respond to emergencies, having someone physically present to respond to emergencies. Additionally, many hospitals have people or patients who present who aren't necessarily scheduled as it were to deliver at that hospital. And so the OB hospitalist then became the attending physician for those patients when, you know, their traditional prenatal provider doesn't go to that facility. So probably those were the two most common things, responding to and managing emergencies and caring for patients who didn't have a physician or midwife at that facility.

Prakash Chandran: And so that was kind of the state of how things were when you first became a hospitalist, you know, kind of responding to emergencies and really becoming the attending for patients that were unscheduled. How has that evolved over the years and how has the role for OB hospitalist changed on labor and delivery?

Dr Mark Simon: Yeah, I think what's happened over the years is a recognition that physicians and midwives who are OB hospitalists, who stay in the hospital and dedicate their career and clinical career to working in these institutions become very adept at managing the care of a patient in that setting. So the OB hospitalists are actually very well suited to, you know, managing what's going on with the patients who are admitted and they can become more adept, as I said, with dealing with these conditions. And so now, what we're seeing is that the OB hospitalists are more actively engaged on the labor and delivery unit, the postpartum unit, the antepartum unit in the sense that the OB hospitalist has a clear understanding and situational awareness of what's happening with multiple patients, even if the OB hospitalist isn't the one who's going to be doing the delivery itself.

Prakash Chandran: So I imagined that this also changes the way that hospitals look for an OB hospitalist provider. Is that correct?

Dr Mark Simon: Yeah, I think it does in the sense that an OB hospitalist really has to be a team player. They have to be the ones to help coordinate care on those units that I mentioned and communicate well with all different participants in that care model. So that means the nursing staff, anesthesia, the private physicians, other departments within the hospital, et cetera. And so the OB hospitalist serves almost an, you know, air traffic control kind of role in helping to manage the quality and efficiency of care on the entire. unit. And so you're looking for those skillsets of communication, in particular being good communicators and being good team players with various disciplines in the hospital.

Prakash Chandran: So, I guess this leads me to a broader question around the evolution of OB hospitalist medicine. You obviously have articulated a lot of the change that you have seen since you started in 2009. But how do you see things evolving or changing in the future, you know, in the next 10 to 15 years?

Dr Mark Simon: Yeah. First of all, I think we're going to see more and more facilities have physician and midwife teams that are dedicated to caring for obstetrical patients in the hospital. And so you're going to see these teams truly take ownership of the quality and outcomes for those patients. And while they may still not do a hundred percent of the deliveries, but they're going to be much more actively engaged and part of the care team for those patients. And what I see happening there is that when a patient comes to the hospital for an obstetrical reason, it will be very common for the OB hospitalist to be officially recognized as part of that patient's care team. It will be unsurprising for an OB hospitalist, whether it's a physician or midwife, again, who comes by, sees the patient, is aware of any complications that may arise with that patient and helping the management therein of those complications, so that patient and the newborn have the best possible outcomes that we can get in a hospital setting.

And again, it's not an effort to remove the primary prenatal care provider that the patient may have been seeing. It should be seen as an adjunct. We're here as part of the care team. Again, with the goal, we want every patient who presents to an obstetrical unit to have the best possible outcome.

Prakash Chandran: Yeah, that makes a lot of sense. And that kind of leads me to another question that you touched on. What has been the patient disposition towards an OB hospitalists, you know, like how have you seen that evolve over the years?

Dr Mark Simon: Yeah, I think, in general, patients are very accepting of OB hospitalist, especially when they understand the OB hospitalist role on labor and delivery. Patients themselves want the best possible outcome for their pregnancy and for their newborn, of course. And therefore, they're very accepting in my experience of OB hospitalists being engaged in their care, because as long as they understand that the role of the hospitalist is to encourage that positive outcome.

And then the other big change that you've seen in the community at large is you see larger and larger OB practices in the community itself, which means that many patients don't have deliveries done by a person who they may have seen most commonly in the prenatal period. What that means is they're very used to individuals be part of their care team. And I also think lastly, that the patients in 2022 and beyond appreciates the amount of work and time that goes into practicing medicine either as a physician or a midwife. And they recognize that those physicians and midwives can't be around 24/7 and safely deliver care. So it's not uncommon for them to recognize that, "Hey, having someone different as part of my care team is okay. I just want to know that they're compassionate. They care about me or the human being, and they're going to deliver a quality care." And as long as we're meeting those needs, as far as treating them as the individual that they are and working towards delivering the best possible outcome, patients are very accepting.

Prakash Chandran: Yeah, that makes a ton of sense. So, Dr. Simon, just before we close here today, is there anything else that you wanted to share?

Dr Mark Simon: The one thing I would just, say is that 20, 30 years ago when medicine was less complicated, it may be easy to become an expert in all sorts of different areas of obstetrics and gynecology, as well as different areas of medicine. But medicine, as you know, has become more complex. We have a greater knowledge depth as far as these conditions and these areas go. And it's unsurprising to me to see physicians, midwives, and other care professionals within healthcare focused and become experts in specific areas, even within specialties that we may have considered self-contained in previous years. And I think just seeing evolution and change in healthcare is the right thing. We should be changing and we should be evolving and we should always be striving to get better so that we can deliver on our promise as I've said before, to delivering the best possible outcomes for patients.

Prakash Chandran: Well, I love that and I definitely couldn't agree more. Dr. Simon, thank you so much for your time today.

Dr Mark Simon: Thank you.

Prakash Chandran: That was Dr. Mark Simon, Chief Medical Officer at OB Hospitalist Group. To learn more about OBHG and OB hospitalist medicine, you can visit obhg.com. Thanks for checking out this episode of the OB hospitalist group podcast series. If you found this podcast to be helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. My name is Prakash Chandran. Thanks again, and we'll talk next time.