Some health systems explore laborists idea | USA Today | 8.9.05
Practice takes pressure off doctors and helps lower costs of malpractice insurance
When Legacy Health System of Portland, Ore., announced that it would open a second hospital 15 miles away in Vancouver, Wash., it met with some unexpected grumbling — from obstetricians.
Schedules worked out among groups of community obstetricians allowed most doctors to have a few nights off between being “on call” to deliver babies. A second hospital would double coverage needs and could result in doctors having patients in both simultaneously.
“I was greeted with hostility,” says a wry Duncan Neilson, chief of women’s services at Legacy.
But then Neilson thought, why not hire doctors who will work only in the hospital, mainly delivering babies?
By hiring what have been called “laborists” and paying their malpractice insurance costs, the hospital could take the pressure off community doctors and possibly help with two related problems. Nationwide, fewer doctors, including obstetricians, want to serve “on call” for hospital emergency rooms. And rising malpractice insurance costs are causing some obstetricians to retire or cut back on OB services.…
Subspecialization by venue? How did the corporate practice of medicine come about? By having big carrots:
- better control of on-call obligations
- shifting malpractice insurance to the “deeper pocket”
- better control of office practice
