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Certified Nurse Midwives Meet the Huge Demands of Women's Healthcare
Midwifery care is on the rise, given the continued decline in the number of physicians providing obstetric services. Therefore, there are higher patient-to-physician ratios, increasing operational costs and declining reimbursement. Faced with these challenges and impending healthcare reform, many Obstetric/Gynecological practices are hiring Certified Nurse Midwives (CNMs) to increase efficiency and address the needs of their patients.
Training and Education
Certified Nurse Midwives are registered nurses who have completed graduate level training in midwifery and have passed a national certification exam. By 2010, CNMs will be required to hold a graduate (Masters) degree. According to the American College of Nurse Midwives, there are more than 11,000 CNMs practicing in the United States and this number is expected to grow by 20–30% over the next 10 years.
Scope of Practice
Considered primary healthcare providers, CNMs most often provide comprehensive medical care for relatively healthy women from puberty to menopause and beyond. They provide an array of healthcare services including gynecological examinations, contraceptive counseling and family planning, labor and delivery care, postpartum care, well-women care, menopausal management and reproductive education. In many practices the CNM provides the majority of low risk obstetrical care, which allows the physician to concentrate on high risk cases and the more lucrative and complicated gynecological cases. Some CNMs have extended their scope of practice to include serving as first surgical assist at cesarean sections as well as performing circumcisions, colonoscopies, and ultrasonography.
The role of a CNM will vary between practices and hospitals. Some practices may choose to have the CNM provide only office-based care and education; others may utilize them for hospital rounds and first call; or some will fully utilize the CNMs' skills for delivery. However, it is ultimately the decision of each hospital to determine if they will credential a CNM to be the primary provider for births in their hospital.
Trends
Current trends indicate the obstetrical patient base growth rate far surpasses the rate of OB/GYN physicians entering practice. This, combined with the increasing number of retiring physicians or those giving up their obstetric service, makes for an even gloomier outlook for the OB/GYN specialty. It is likely CNMs will increasingly become a significant resource in bridging the gap by providing efficient, competent and cost effective women's healthcare services.
For additional information on how best to incorporate a CNM into a clinical practice, please contact us.
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