In today’s healthcare climate, a greater number of physicians, including OB/GYNs are moving away from the solo practice model and starting to form large groups. From the physician perspective, it allows them to have back-up in case they are in a delivery or an emergency surgery. In addition, they don’t have to cancel patients in the office who have, most likely, taken time from work to schedule the appointment. Being in a group also facilitates peer consultation. Despite rigorous training, physicians have not been exposed to all clinical scenarios that they may come across on a given day. Thus, it is beneficial to be able to collaborate with other physicians of various backgrounds and experience so they can draw from one another’s experiences to supplement their own.
As a patient, the notion of being cared for by multiple physicians during your prenatal care may be disheartening. Furthermore, your OB/GYN has seen you vulnerable for your well-woman exam so what patient want to do that for more than one doctor? Receiving care from a team of physicians in a group scenario seems to be more palatable in the Family and Internal Medicine space than that of OB/GYN. This is because many patients idealize their pregnancy and prenatal care. Most patients expect to see the same physician for every appointment during their pregnancy and seek to develop a relationship with the doctor whom they are trusting to safely bring their child into the world. In an OB/GYN group practice where your OB may not be the one delivering you, it is ideal for patients to meet each of the group practice members, assuming that they share an office.
I empathize with these concerns having recently given birth to my daughter. However, being an OB/GYN myself, I was understanding when I had to wait 45 minutes for an appointment because my doctor was in a delivery or when my appointment had to be rescheduled because of an emergency at the hospital. I did not expect my doctor to come into the hospital on a weekend when I was admitted for observation due to severe abdominal pain. I started contracting fairly regularly the weekend my doctor was on vacation, and I thought, “Oh no! I might have to have this baby without my doctor!”, even though I knew her partners were quite capable of providing great care.
More importantly, many OB/GYNs are practicing in groups and share weeknight and weekend call with other OB/GYNs because it allows them to be more present for their families. I appreciate my one weeknight per week and one weekend per month of being on call so much more now that I have an infant because time has become more precious than ever. Having this time off also decreases rates of physician burnout by allowing us to prolong our careers and take care of multiple generations of patients.
If you will be receiving prenatal care from a physician who works in a group and/or shares weeknight and weekend call with other OB/GYNs, ask the following questions:
1) In what situations would another physician take care of or deliver me?
2) Will I be able to meet your call partners during the course of my prenatal care?
3) Are there any services that your call partners do not offer, i.e. circumcisions, TOLAC (trial of labor after cesarean), forceps or vacuum delivery?
4) Will your call partners honor my birth plan?
5) If there is an emergency, who will take care of me?
6) Will your call partners honor the delivery plan that I have made with you as my OB/GYN?
7) How will your call partners know about my medical history or any complications I have had during my pregnancy?
Knowing the answers to these questions will help you determine if you and the practice are a good fit. So I say to you, don’t be afraid of the group practice, embrace it. It’s for your benefit as well as for the benefit of your OB/GYN.
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