Clinic days involve under 20 patients, typically around 15, allowing adequate time for the conversations that build relationships in a community practice. The prenatal workflow distributes care logically: nursing staff handle intakes and first prenatal visits, patients see a physician around 12 to 14 weeks to confirm everything is progressing well, then rotate through the provider team before returning to physician care at 35 to 36 weeks for delivery preparation. This structure gives you dedicated time with high-value visits rather than routine checks that advanced practice providers handle effectively.
You will maintain active surgical skills with dedicated OR block time on the first and third Wednesdays each month, plus a fifth Wednesday when applicable. These full-day blocks accommodate your scheduled cases, typically two to three major procedures and two to three minor cases per session. Additional OR time slots exist throughout the month for cases that cannot wait for block time. The practice serves as the surgical referral center for surrounding communities, bringing gynecologic cases from family medicine providers across the region who lack surgical capabilities.
The hospital supports robotic surgery with a Da Vinci system available for physicians who wish to use it. The current OBGYN team does not utilize the robot, but administration welcomes candidates with robotic training and would support that practice style. For physicians seeking to maintain or develop robotic skills, the infrastructure exists.
The call schedule represents the most significant adjustment for physicians accustomed to laborist models or large group coverage. You will take approximately 10 call days per month with a 1:3 weekend rotation once the full team is in place. This is home call with a 30-minute response radius, not in-house coverage. A call room exists at the hospital if you prefer to stay close during active labor, but you are not required to remain on campus.
The reality of call here differs from the raw numbers. With 175 to 200 annual deliveries spread across the year, many call nights are quiet. The unpredictability inherent to obstetrics remains, but the volume does not compare to high-volume urban programs.
Practicing in a rural critical access hospital does not mean practicing in isolation. Cody Regional Health maintains strong relationships with Intermountain Health in Billings, Montana, providing readily accessible maternal-fetal medicine and gynecologic oncology consultation through the shared Epic EMR system. You can message specialists, review their notes in real-time, and coordinate complex care without the friction that plagues referral relationships elsewhere. The MFM team is described as exceptionally supportive and accessible, providing backup that allows you to manage moderate-risk pregnancies confidently while having clear pathways for cases requiring tertiary care.
The hospital transfers patients appropriately rather than asking physicians to practice beyond reasonable scope. Patients with significant fetal anomalies, extraordinarily high-risk pregnancies, or conditions requiring subspecialty delivery go to Billings. The practice accepts elevated BMI patients that surrounding hospitals cannot accommodate due to anesthesia limitations, managing that population with appropriate support. You will see interesting, moderately complex cases that keep the work engaging while knowing transfer protocols protect you and your patients when situations exceed local capabilities.