title: The laborist model of obstetric care: we need more evidence.
abstract: Literature suggesting improved patient outcomes and patient satisfaction with the hospitalist model of inpatient medical care coupled with the desire to improve provider satisfaction led to the introduction of the laborist in obstetrics. This represents a significant change in the way obstetrics has been experienced and practiced from both a patient and provider perspective. The laborist was designed as a plausible model of obstetric care delivery where hospitals employ physicians to provide continuous coverage of labor and delivery units without other competing clinical duties. Anecdotal use of the laborist model in the provision of obstetric care is growing rapidly, despite the lack of research regarding its impact on maternal outcomes, neonatal outcomes, patient and provider satisfaction, and graduate medical education. We provide an overview of both the positive and negative attributes of this model of obstetric care delivery, discuss the current state of research addressing these attributes, and propose a research strategy to improve understanding of the impact of this model of care delivery.
authors.affiliation: Maternal and Child Health Research Program, Center for Research on Reproduction and Women's Health, University of Pennsylvania Perelman School of Medicine, Department of Obstetrics and Gynecology, Philadelphia, PA, USA.
authors.forename: Sindhu K
authors.initials: SK
authors.lastname: Srinivas
authors.forename: Scott A
authors.initials: SA
authors.lastname: Lorch
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D020445:Hospitalists / Q000193:education; D006801:Humans; D007588:Job Satisfaction; D017146:Models, Organizational; D009774:Obstetrics / Q000193:education; D009775:Obstetrics and Gynecology Department, Hospital / Q000458:organization & administration*; D017060:Patient Satisfaction; D011247:Pregnancy; D014481:United States; D000078329:Workforce