CORE LINK: “COLLABORATIVE OBSTETRICAL RESOURCE” PROPOSAL FOR LOW RISK OBSTETRICAL SHARED CARE CLINICS: PROJET POUR DES CLINIQUES DE SOINS OBSTÉTRICAUX CONJOINTS POUR LES FEMMES À FAIBLE RISQUE

As a growing number of women and their families seek low risk obstetrical care, the number of maternity care providers falls. For family physicians, this is due in large measure to an unsustainable model of practice that includes constraints on lifestyle, prohibitive malpractice insurance and unsatisfactory remuneration. Ontario, British Columbia, Manitoba, Quebec and Alberta have regulations in place for midwifery to address this growing problem. However, due to the limited scope of practice for midwives, the small number of practitioners, and the profession's attrition rate in general, there continues to be an enormous gap between the demand for access and the supply of low risk obstetrical care providers and services.i It is proposed that CORe LINK, Collaborative Obstetrical Resource Link, will develop shared-care clinics across the country, called Maternity CORe sites. These clinics will work within an interdisciplinary model developed to harness the unique skills and expertise of all community based, primary care professionals who work with the low risk obstetrical population, while addressing the barriers and challenges that these practitioners face in doing their work. CORe LINK is currently seeking approval in Ontario to pilot this project. A proposal for the CORe LINK project was submitted in November 2003 to the Primary Health Care Transition Fund.ii CORe LINK approval is pending to begin a fully integrated model of service delivery. As an interim approach, a two-phase process has been proposed that does not interfere with existing models of care. CORe LINK will utilize common clinical and evaluation tools to ensure that there will be a multi-centred approach to data collection and analysis across all Maternity CORe sites. This article will discuss how the CORe LINK project can both entice new practitioners to practice family centred obstetrics and conserve and protect established professionals from leaving through the development of an interdisciplinary approach to practice, funded through an Alternative Payment Plan within a shared liability model.