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Making It Work: Successful Collaborative Practice

DeJoy, Susan CNM, PhD; Burkman, Ronald T. MD; Graves, Barbara W. CNM, MPH; Grow, Daniel MD; Sankey, Heather Z. MD; Delk, Carolyn MD; Feinland, Julie CNM, MSN; Kaplan, Janet CNM, MSN; Hallisey, Anastasia CNM, MSN

doi: 10.1097/AOG.0b013e318229e0bf
Current Commentary

There are three major examples of collaborative programs between certified nurse–midwives (CNMs) and obstetrician–gynecologists at Baystate Medical Center in Springfield, Massachusetts, within the Department of Obstetrics and Gynecology. One program is a midwifery practice that serves a diverse population in a hospital-based office, four neighborhood health centers, and a correctional facility. Another program provides a triage function for patients who present to the hospital with obstetric or gynecologic problems. The third program introduces a team approach to the education of residents with a CNM having primary responsibility for teaching normal obstetrics to first-year residents and medical students in collaboration with attending physicians. Keys to success include an understanding of the principles of collaborative practice, the use of a detailed practice agreement between midwives and attending physicians, keeping open lines of communication, understanding and accepting differing philosophies of practice, and, most importantly, maintaining trust across all levels of providers.

Three collaborative programs between midwives and obstetrician– gynecologists have been successful at Baystate Medical Center.

From the Division of Midwifery and Community Health, Division of General Obstetrics and Gynecology, and Obstetrics and Gynecology Residency Program, Baystate Medical Center, Springfield, Massachusetts; and Tufts University School of Medicine, Boston, Massachusetts.

See related editorial on page 503 and related articles on pages 663, 673, and 678.

Presented at American College of Nurse-Midwives 56th Annual Meeting and Exposition, May 24–28, 2011, San Antonio, Texas.

Corresponding author: Susan DeJoy, CNM, PhD, Chief, Division of Midwifery and Community Health, Baystate Medical Center, 689 Chestnut Street, Springfield, MA 01199, Assistant Clinical Professor, Tufts University School of Medicine; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2011 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.