Our Team
GINGER BREEDLOVE, PhD, CNM, FACNM, FAAN
PRINCIPAL CONSULTANT
Solving the shortage of women’s health care providers in the US is a daunting task that will involve coordinating stakeholders from every level of the medical community. There are few people in the world today who understand this complex issue as well as Ginger Breedlove, PhD, CNM, APRN, FACNM, FAAN.
LESLEY RATHBUN, MSN, CNM, FNP, FACNM
SENIOR CONSULTANT
The main job of any OBGYN or Midwife is to ensure the health of mothers and babies, but birth in the United States is still a business. Lesley Rathbun has spent the last 30 years advocating for women’s health while becoming a well-known figure in the fields of birth center entrepreneurship and legislation.
JOSEPH BOOTH, JD, Mdiv., FAAML
IN-HOUSE COUNSEL
Today’s Physicians and Midwives spend the majority of their early careers learning how to administer care. So much so that learning the legal and business aspects of running a practice simply isn’t feasible. The legalities surrounding maternity care require careful navigation by a knowledgeable advocate.
Connect With Us
Honored to share thoughts on key issues in Midwifery.
Join us Monday, March 1. Registration below.
midwivesofnj.com/spotlight-on-midwifery-webinar-1/
Spotlight on Midwifery: Webinar Series | The Midwives Of New Jersey
midwivesofnj.com
The Midwives of NJ created NJ Symposium for Physiologic birth as part of our commitment to educate on and elevate evidenced-based, physiologic birthWe are now beginning to see Fair Market Value creep into discussions around salary cap for Midwives.
This may be disguised and not written within a contract, more likely heard when faced with negotiating a salary raise within a health system or physician-owned practice.
Compliance standards for physician compensation arrangements include more than half of practicing physicians now employed by hospitals or integrated delivery systems.
Compensation for physicians who practice in independent groups has traditionally been defined as the cash that remains after expenses are paid. Physicians employed by hospitals or integrated delivery systems generally earn W-2 compensation based on work RVU production, quality measurements, patient satisfaction and other criteria. (Yeah wRVUs are back again)
What's the problem? Negotiations over compensation arrangements always involve legitimate self interest. The employee trying to obtain as much compensation as possible, while the employer attempts to obtain your services at the lowest possible cost. The big survey giants on compensation like MGMA run the market on physician percentiles that represent Fair Market Value (FMV).
Now the creep is in to Advanced Practice Providers. HOWEVER, do the laws apply to midwives and what do employers want you to believe? Can you answer these questions?
Does Fair Market Value apply to Midwives?
Do Stark Laws apply to Midwives?
Are you prepared to argue the facts?
Do this apply to reimbursing physicians for collaborative practice arrangements?
Preparing a webinar to lay out the FACTS! Once again midwives are facing additional compensation barriers (similar to RVUs) that are not applicable or comparative concepts as applied to physicians.
Join us on Thursday, March 11th 6-7:30 PM CST. We will be presenting a comprehensive review of Fair Market Value and Midwifery implications based on a review of the law.
Send a request to join on the Contact Us Form on #GrowMidwives website www.growmidwives.com
What do you note in the 3 maps below depicting Advanced Practice Providers in the US?
These are the most recent data collected by the Bureau of Labor Statistics (BLS) in 2019. Updated data will come out in the spring. The numbers will likely remain similar when you factor in retirement, attrition and exiting the workforce due to Covid.
*Note national data of practicing roles. www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
Nurse-Midwives — 7,000 (the BLS does not include the CM)
Nurse Anesthetist — 44,000
Nurse Practitioners, such as FNP, WHNP, PNP — 200,000
From our lens, jobs are increasing for Midwives in the US. The women’s health workforce has now entered the serious shortage predicted years ago. However, most systems and physician owned practices are not familiar with the scope and role of this profession. How could they? There are so few midwives in full scope practice burdened with a variety of employment models, working within absurdly diverse regulations overseen by 50 states, and face additional credentialling and privileges determined by every hospital in the US.
It’s complicated beyond reason in a country where every provider should be practicing to the highest level of their education and training.
What can be done?
Champion midwifery as a key provider in the US.
Challenge barriers to midwifery integration.
Choose a midwife for health care services.
#GrowMidwives We are working with three health systems to assist in designing full integration. #Heretohelp
An Academic Teaching center that demonstrates collaborative, respectful care by physicians (OBs and Family Medicine) and midwives, ALL working together!
Take Note — this model, working to increase BIPOC providers in care of childbearing families is possible.
#GrowMidwives
unmhealth.org/stories/2021/01/racial-bias-obgyn-care.html?fbclid=IwAR0agYtd9idLTVr0hJULn_O6MOpNDH...
How UNM Health Strives to End Racial Bias in OB/GYN Care
unmhealth.org
Racial bias is a hot topic. But the centuries-long struggle won't end without personal action. Explore UNM's efforts to end racial bias in OB/GYN care.Continuing to assist midwives with lack of education about wRVU metrics in employment contracts, noting that in many agreements the employer sets benchmarks for employed midwives that an OB/GYN is expected to reach.
Don’t be passive in understanding what you are are asked to agree to. Contracts with 5 pages explaining Incentive Bonus and wRVU compensation are likely misleading and completely unattainable.
On the #GrowMidwives website our most recent recorded blog is a 90 minute discussion about Midwives and wRVU compensation. You can also find other recent discussions on landing a job, contracts and professional liability policies.
Up next - a webinar discussing Fair Market Value and the notion of “capping” midwifery salaries.
#GrowMidwives
#StayInformed
growmidwives.com/blog/