The last thing a high risk expectant mother wants is to be in the emergency room waiting to be seen by an intern or trauma care doctor while her specialty OB-GYN physician has to be contacted. Northwest Health is hoping to avoid that scenario.
Northwest Health CEO Sharif Omar said as the Northwest Arkansas region continues to grow so does the need for a dedicated OB-ER which the hospital group recently opened at its Willow Creek Women’s Hospital located in Johnson.
Omar said Willow Creek is the first hospital in Arkansas to provide women’s care by a board certified obstetrics and gynecology doctor (OB/GYN) 24/7 in the emergency department. He said the goal of the investment is to give pregnant women the specialized care they need, regardless of the time or day. He said other conditions such as tubal pregnancies that require immediate attention by a specialty doctor can also be handled at the new OB-ER. There are five board certified OB-GYN physicians who rotate through the Willow Creek OB-ER. The hospital group didn’t disclose the additional costs it incurred with offering this service, which are primarily related to increased staffing costs around the clock.
Omar told Talk Business & Politics the Willow Creek hospital is the perfect fit for the OB-ER and other women’s gynecological emergencies. While the Bentonville hospital does deliver babies, he said there is not an OB-GYN on call in the emergency room. He said neither of the two competing hospitals in the region are set up with OB-GYN specialists in their emergency rooms.
“It’s just not possible because those facilities treat a multitude of conditions in their emergency rooms from behavioral health to trauma. If a woman shows up full-term at a typical ER they are sent up to labor and delivery and evaluated by a nurse while the doctor is called. This new service allows women to get immediate care by a specialist who can evaluate the situation right away and call their doctor or midwife as well,” Omar said.
He said any women needing an OB-GYN can use the new specialty ER center at Willow Creek as Northwest Health has agreed to work with all family physicians and midwives in the community. Omar said should a pregnant woman need immediate attention she could go to the OB-ER and be evaluated immediately by a specialist. Then if she needs to be hospitalized and chooses another facility she could be transferred as long as she is stable.
The most important thing for the expectant mom is to get the care she needs, when she needs it, he added.
During the first month, Omar said the Northwest Health team spent a lot time meeting with other family physicians and midwives who deliver babies. While some health care professionals thought their patients might not like seeing a stranger, Omar said the same concern was raised when adult hospice was first introduced. He said during an emergency, speciality care usually trumps those concerns.
Omar said in the rural areas on the perimeter of Northwest Arkansas they aren’t any OB-GYN specialists and high risk pregnancies for older moms or women trying to deliver vaginally after a cesarian birth require an OB-GYN be present during delivery. He said they can be cared for at the Willow Creek OB-ER, when in the past some of them would have been sent to Little Rock.
The number of women giving birth without having seen a doctor regularly during the pregnancy continues to be an issue in spite of the mandated insurance requirements from ObamaCare. Because the women may show up in the emergency room with false labor or other issues, the OB-ER can evaluate if labor is active or if it’s something else. The OB-ER specialist can deliver the baby if it’s time or send them home if not, eliminating the need to admit the patient unnecessarily.
One other benefit of OB-ER is that it allows family physicians and community doctors who are trying to maintain a work-life balance not to be on-call 24/7 because they can rely on the OB-ER to access the emergency situations on their behalf as an extension of the patient’s personal doctor.
“This should hopefully help us be able to recruit more OB-GYN specialists to the region,” Omar said.
The specialty ER is part of slow growing trend across the country, according to Omar who said the first specialties have been in geriatric care, but then obstetrics and women’s care along with behavioral health have followed. When asked if Northwest Health is considering expanding its specialty ER presence, Omar said the next logical move would be to do something with behavioral health.
“We are are just in the evaluation stage at this point. But Springdale has a behavior health unit that stays at capacity. Perhaps Northwest Health could be an extension of crisis behavior health at some point in the future. We are contemplating how that would flow but have no formal plan in place,” he said.
A study by RAND Health found that even in areas where primary care was plentiful, it’s not uncommon for primary care doctors who have a relationship with the patient to send them to the emergency room. This is putting more pressure on emergency room physicians, which is another reason specialty ER programs are taking root in places like Mount Sinai in New York City, which reported last year 10% of its emergency room visits were from patients over 65. That hospital set up a geriatric Emergency Department last year.
In Newport Beach Calif., Hoag Memorial Hospital opened its dedicated OB Emergency Department in August 2015, saying that emergency room doctors felt uncomfortable treating pregnant women and taking on that higher level on liability for which they are not specialized.
Health experts also said emergency room visits have increased since there are more people insured. In fact, the growth of the insured population has outpaced the number of primary care physicians and it will take time for the infrastructure to catch up.