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.