The laborist: A new focus of practice for the obstetrician

The practice of obstetrics has changed dramatically in the last decade. Evidence exists for a marked increase in professional dissatisfaction, substance abuse, poor personal relationships, and burnout. These conditions are now being seen in younger physicians and in training programs. Physicians have stopped practicing obstetrics at a much younger age and are increasingly quitting training programs. These findings, along with the recent professional liability insurance crisis, leave many communities with a shortage of physicians who practice obstetrics. A potential solution for alleviating some of these conditions is the introduction of a physician whose sole focus of practice is managing the patient in labor. This physician, called the “laborist,” may be able to improve patient care and satisfaction because the laborist will have no other distractions during this time. Also, the laborist will remove from the obstetrician the need to be always available to the laboring patient, which potentially may decrease stress, improve physician well-being, increase length of professional practice, and decrease burnout. (Am J Obstet Gynecol 2003;188:310-2.)