Modernizing Maternity Care: Spotlight on Lauren Demosthenes, MD, Senior Medical Director

At ACOG's Annual Clinical and Scientific Meeting this year, Babyscripts Senior Medical Director, Dr. Lauren Demosthenes, joined Dr. Neel Shah from Maven Clinic and Dr. Pooja Mehta from CityBlock Health to talk about digital tools for delivering more equitable care. This topic of equity was top of mind at the meeting, with attendees agreeing on the benefits of digital health and advocating for infrastructure that keeps pace with innovation (ie, the need for nationwide broadband, reimbursement codes, etc.).

Dr. Demosthenes' takeaways from ACOG included the importance of implementing PATH recommendations for a reduced model of care, an efficiency that has become increasingly essential as health systems struggle with labor shortages and strained budgets. She also noted conversations around care models that address social determinants of health as well as clinical, providing wraparound care for women that may have low clinical risk but high social risk.

[Read: ACOG Releases New Pregnancy Prenatal Care Recommendations]

Now in her second year as Senior Medical Director at Babyscripts, Dr. Demosthenes touches every aspect of the business: advising on product development, contributing to clinical content, guiding the executive team, and providing insights into the patient and doctor relationship that only 35 years of working as an OB/GYN can produce.

We've found Dr. Demosthenes' clinical perspective to be a critical part of our success as a digital health solution. In her own words, read about the expertise that she brings to the table and what drives her mission, and how she's always been a fan of disruption:

Throughout my career as an obgyn physician, I've always been focused on how we can achieve good health and wellness with education and prevention. I often saw patients who were not in optimal health, but I also saw many healthy patients who were struggling with annoyances of conditions and wanted to learn more about how to handle them. It's always been my modus operandi to empower patients with education about recognizing normal and abnormal symptoms, to  give them options for management and treatment, and to encourage them to refrain from treatment that was not necessary.

I've long been at odds with the problem of overtreating in the system, and bothered by the cost and inefficiencies of medical care. I saw many tests being performed in the office and hospital setting that weren't necessary, and felt guilty as my patients waited 30-45 minutes to see me for a 10-minute prenatal visit. In my opinion, there had to be a better way to help patients.

Modernizing Maternity Care

I became deeply critical of the standard delivery of care and began to consider other options. Could I provide better education between visits? Could I teach patients to track and understand their blood pressure and weight data? Did patients really need to see me in person for every visit or could I empower them to be part of their own care from their work place or home?

As I began teaching medical students and residents, I was reminded that my way of practicing was not always popular. Ordering tests “just to be thorough” and to gather more information was often the norm. Many of my colleagues believed that patients enjoyed coming in for frequent visits and liked to have tests run. I even had peers tell me that they did some of this to earn the 99212 or 3.

I didn't disagree that some patients enjoy their physician relationships, but I questioned if some patients were burdened with avoidable financial stresses, or follow-up testing for incidental findings on scans or lab tests that may not have been necessary. I also believed that we should offer choices to patients – so that those who wanted other ways of receiving care could opt in or out.

While I practiced, I became involved with like-minded national groups and practitioners across the country who were asking similar questions. Around the same time, I was asked to serve as the medical director of high value care and innovation for my department – “I’m going to pay you to disrupt” was the term that was used. A perfect place for me.

Digital Tools for Obstetrics

And that’s when I met the founders of Babyscripts. Like me, they felt that prenatal care could be delivered more efficiently and that education for patients could be improved. An app could provide education through daily and weekly bite sized bits of information. Pregnant people could actually be part of their care and learn to take their own BPs – knowing that their care team was right there with them monitoring the results. Fewer in person visits would be needed.  Less inconvenience and  waiting in the waiting room for a 10 minute visit and more involvement in their own care for the pregnant person. Maternity care had changed little over the past 90 years – wasn’t it time to modernize?

The journey led me to leave my traditional practice to become (more of) a “disruptor” – I've been privileged to serve on and chair the ACOG Annual Clinical and Scientific Program committee, edit the series “Break that Practice Habit” for OBG Management (a series to challenge obgyn health professionals to question why they do what they do), serve as a panelist for the ACOG/U. of Michigan collaboration (miPATH) to redesign maternity care, and even do some work with SAHMSA and Heritage Cares to improve education for medical students and the community around substance use disorder – a growing problem in our country.

That's just a little insight into what I do now -- including, of course, serving as Medical Director for Babyscripts. All of these roles work together to support improving and modernizing maternity care for women. Let’s do it!