To the Editor:

I have been “Sharing Maternity Care” [March 2003, page 37] for nearly two years, providing prenatal care to my patients and having their babies delivered by an obstetrician. It began as a response to hospital politics, but then rising malpractice rates made it prohibitive for me to deliver babies. I’ve found this arrangement satisfactory for my patients and me. Developing a relationship with one doctor helps a patient feel more comfortable asking questions. Instead of seeing multiple doctors, as is common in many large ob/gyn practices, most patients see me for the vast majority of their prenatal visits. After about 26 weeks, the patient sees the obstetrician for an ultrasound and exam. If there are signs of complications at any time, the obstetrician takes over the patient’s care. Otherwise, I see the patient through 36 weeks or until labor begins.

I note the level of service incurred at each visit so that if I relinquish care before 36 weeks, I can total the charges and submit a claim. If I see the patient more than 36 weeks, I charge my usual prenatal-care fee. I’d encourage other physicians, particularly those wanting to “ease out” of obstetrics, to consider the shared care model.