From Our CEO: Kaweah Delta's Proposed Laborist Program
KAWEAH DELTA’S PROPOSED LABORIST PROGRAM
From Gary Herbst, Kaweah Delta Chief Executive Officer
Last year at Kaweah Delta, our outstanding team of physicians, midwife
and staff delivered more than 4,700 babies. The vast majority of these
babies were delivered by the personal physician of the expectant mom.
However, in some cases, mom’s personal physician may not be available
at time of delivery and the baby is delivered by a known-physician colleague
of the patient’s personal physician. In other cases, mom does not
have a personal physician and her baby is delivered by a physician participating
in a formal obstetrical on-call program sponsored and paid for by Kaweah Delta.
In years past, almost all obstetricians on staff at Kaweah Delta took “call”
for their own patients or their medical group and took their turn at providing
“general call” for patients who did not have personal physicians
and the emergency department. However, over time, as patient volumes grew,
community obstetricians, like those of Visalia OB-GYN Medical Associates,
withdrew from general call and now only provide call for their own patients
and their medical group colleagues. This is perfectly fine with Kaweah
Delta and we have no intention of changing this. However, we now only
have a handful of community physicians who participate in general call
and obstetrical coverage for patients without personal physicians.
As more hospitals across the country face similar circumstances of declining
coverage for patients without personal physicians, formal “Laborist”
programs have emerged as an alternative model for hospitals to staff their
emergency departments and labor and delivery units.
A Laborist program generally consists of one or more highly-skilled and
trained, board certified obstetricians. Often times, a Laborist physician
comes from the local community where a physician in private practice may
want to devote their time to in-hospital service. A Laborist is physically
present in the hospital 24 hours per day, 7 days per week. With a Laborist
program, community obstetricians no longer have to take general obstetrical
call for patients who do not have a personal physician.
For the most part, the primary responsibility of a Laborist is to deliver
babies for moms who do not have a personal physician. However, a Laborist
is also available to assist a private community obstetrician in an emergency
situation where mom’s personal physician cannot arrive to the hospital
in time to deliver the baby or save a mom’s or baby’s life
in the event of an unexpected hemorrhage, an ectopic pregnancy (pregnancy
outside the uterus), or some other life-threatening situation. In these
situations, the Laborist is in direct communication with the personal
physician, working together before the personal physician arrives at the hospital.
Our proposed Laborists will not be running our Family Birth Center and
will only be there to take care of moms without personal physicians and
to assist in emergency situations. Local community obstetricians will
always deliver the babies of their patients except when an emergency presents
itself faster than their physician can arrive to the hospital.
Lastly, Kaweah Delta’s decision to implement a Laborist program was
only made after receiving the support and approval of our Medical Staff’s
Department of Obstetrics, chaired by a local community obstetrician. While
a formal Laborist program is more expensive for Kaweah Delta than what
we are currently paying community physicians for taking general call,
we believe the added cost is worth the benefit of having dedicated obstetricians
available for moms without personal physicians and for the ability to
immediately respond to unexpected emergency situations for all expectant
moms. Also, patients that come to our Emergency Department or to our Obstetrical
Triage Unit (located next to our Labor and Delivery Unit) for concerns
about premature labor or other pregnancy related matters will not experience
any increase in out-of-pocket healthcare costs.
Thank you for taking the time to read this letter. I hope it addresses
your concerns and corrects misinformation that you may have received.
Please do not hesitate to contact me if you have more questions. Thank