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[Dessau]

I practice in a 110 bed community hospital with less that 1000 deliveries per year.  Our OBs are insisting that there be a anesthesia provider in house 24/7, even if there are no patients in labor.  Is this reasonable?  All our providers are within 30 minutes of the hospital which meets the ACOG requirements.  I am looking for an answer to this demand.  I might also add that the hospital CEO doesn't think this is reasonable but the OBs are threatening him with taking cases to other hospitals and so he is caught in the middle.

[yogenbhatt1]

HI,
It is good to have an in house Anaesthesiologist for any institution. But do they have an in house Obstetrician?
If yes, then their demand is valid, seeing it from the eyes of the CEO.
What you all can do is, to keep one person on call and in the premises. We do it this way and charge the hospital as a retainership fees of a certain amount per night and Holidays day plus night duty. If they want you in the premises of the hospital, they have to pay you additional amount unless you are fulltimers and the contract says that one of you will be on the premises round the clock.
Now it is how you work out the same thing in your benefit, along with the benefit of the patient and hospital and the management.
This is my way of looking at the same thing and we are doing it.
Regards

[Dessau]

Thanks for your reply and advice.

[yogenbhatt1]

In our set up we bargained for a retainership fees and got about 80 % of my demand. I also bargained for a small apartment in the premises. There are always, people looking for a job and a place to stay.
Now, If I appoint an additional Anaesthesiologist, I have to pay additional sum for that.
This retainer fees and market value of rental for the Apartment( Part of deal to the person appointed) is sufficient to square it up.
In effect, the whole thing is free to the group and still the job is done. We also make it a deal with the new fellow, that if the night list is heavy, he has to come in action to help the person on call.
In other words, he is being exploited, but the equation has to work.
You are now able to fulfill the hospital need and still without a burden.
Not that it will be right in your setup, but modify and see.