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Comment and Controversy

Younger ObGyns see lifestyle issues as priority

November 2007 · Vol. 19, No. 11

“Laborists, nocturnalists, weekendists. Will the ‘ists’ preserve the rewards of OB practice?” by Robert L. Barbieri, MD

Your readers might want to explore, where they will find articles discussing the laborist model and other paradigms and an overview of laborists. All of the models are voluntary, so docs can use or bypass the program as they desire. This option allows physicians to weigh personal inconvenience and schedule conflicts against the desire to participate in the labor process.

As a resident director who trains and counsels residents, and as a department chair who hires young faculty and community physicians, I am seeing young doctors emphasize lifestyle to a greater extent, and nights on call and labor-and-delivery coverage are major determinants of quality of life—so laborist programs are also becoming central to recruiting.

William J. Mann Jr, MD
Chairman and Gynecologic Oncologist
Jersey Shore University Medical Center
Neptune, NJ

Dr. Barbieri responds: OB practice is changing

I appreciate the thoughtful responses from Drs. Cayer, Lurvey, and Mann. I resonate deeply with the commitment to the traditional model of obstetrics in which a small group of “like-minded” obstetricians personally provides direct care to their patients and cross-cover during nights and weekends. However, all indications are that we are at the threshold of a major change in obstetric practice and will need to lead and adapt to it over the next decade. Many dynamic factors, including the patient-safety movement, the growing desire to better balance family and work-life, and the significant problem of physician burnout are pushing us toward a “laborist” model. The Web site mentioned by Dr. Mann provides a good overview of some of the advantages and disadvantages of the laborist model.

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