OBGYN Hospitalist Program at University Hospital

Fellowship Paper - March 16, 2021


University Hospital has the potential to lose all women’s healthcare services due to physician burnout and the number of physicians wanting to transition to GYN only care and to stop taking OB call. The reduction in the number of physicians taking OB call could exacerbate the burnout due to the vast growing number of unassigned patients presenting to the Emergency Department without adequate OB care. Should a solution not be developed soon, the hospital facility could lose women’s services to the local competitor. This would have a financially devastating impact to not only the facility, but could also greatly impact patient care.

The Physician Medical Group and University Hospital is asking the Integrated Delivery System (Flagship Hospital) for financial and operational support on the development of an OBGYN Hospitalist program. By implementing a 24/7 OBGYN hospitalist program, the current physicians in the community will have better work/life balance, see a reduction in burnout rate and improvement in the area of provider satisfaction. The hospitalist program will allow physicians to have more time in the office treating patients and can potentially increase the number of patients seen each day. This solution will also prevent physicians from having to leave the office during the day for emergencies and will reduce the number of nights each physician has to take OBGYN night call. It is also requested that the service be outsourced to a vendor to provide physicians as it will take the organization too long to implement / hire for such a program.

Based on a business plan proforma, the number of payback years will be 2.55 using cumulative net cash flow calculations. There will be upfront costs to secure the vendor and implement the program (non-capital as the physical infrastructure is in place); however, with the estimated number of increased ambulatory visits, the facility will be able to retain the current physicians and will ultimately be able to grow services over time. It is anticipated that the organization will secure a contract with the vendor for 18 months which will be enough time for the organization to develop a similar program internally.

It is expected that this program will secure women’s services at University Hospital for years to come. The end result will be to also see OB patients well within the gestational period so that pre-natal care can be given and less complications will occur (including less cesarian sections). This program will stabilize women’s services which will help to increase volume across the facility (from birth to death) as it is known that females make the majority of healthcare decisions in the household. For this particular program, it will be important for the organization to develop adequate talking points and collateral to give to patients who may not see their normal physician should they present to the hospital after normal business hours. However, with adequate communication to the public and assuring them of the best continued quality care, this can and will be successful.

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