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Re: breech From: Braun, R. Daniel (rbraun@iupui.edu) Fri Dec 24 05:01:03 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Kpmcl@aol.com: "Re: OB-GYN-L digest 3544" Previous message: Joanne Bulley, MD: "Re: breech" They don't have a choice. That is where it is headed. Why do you think OB-GYN's are doing so much Primary care? It is a shame that we did it to ourselves, by turning out way too many "OB-GYN",s. Dan R. Daniel Braun, MD "If everyone likes you, you're doing something wrong." Kinky Friedman I believe a self-righteous liberal or conservative with a cause is more dangerous than a Hell's Angel with an attitude. Andy Rooney -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Joanne Bulley, MD Sent: Thursday, December 23, 2004 7:03 PM To: Multiple recipients of list OB-GYN-L Subject: Re: breech Dave and Art, I agree - the training just isn't there anymore. I did learn in residency (1981-85) -- but had limited experience. I did, however, join a practice of two docs 50 & 51 yo. Guys who DID know this - and I made it a point to learn from them and be involved with these cases. But ... no one is trained - so it is a skill that will be lost in the US for sure -- Canadian and European docs on the list can comment on their situations. If it is now only OK in the USA for the baby to fall out or do a C/S -- then we should admit it -- and then there would be a gyn surgery residency ( a branch of general surgery?) and the OB woudl fall under midwifery or MFM / Perinatology. What do the young folks think about that? I look forward to the comments. Joanne PS - when responding please truncate how much you send of prior messages so it doesn't go on & on with other messages. At Thu, 23 Dec 2004, David Priver, MD wrote: > >Art, >I agree with you that arguments about whether vaginal breech delivery >is safe or not are essentially moot. No one gets trained anymore, so >the procedure, in the hands of anyone completing residency since, say, >1980 or so, would most likely not be safe. The more important point is >what this sort of "dumbing down" of our specialty says about where the >field of OB/GYN is headed. The same arguments could be carried on >about forceps deliveries or almost any procedure in which dexterity and >judgment are required. (Note how episiotomy has been determined to be >always bad; no longer can one exercise thoughtful judgment. I suspect >that VBAC will soon be in this same category). What is hard to ignore >is the sense that there are powers afoot who would prefer to see OB/GYN >just disappear, to be replaced by far less expensive (and less >well-trained) alternative practitioners who can catch a baby or, >failing that, can summon a perinatologist. Perhaps that direction is >for the best. Maybe it will produce just as good results less >expensively. My point, however, is that if this is the direction we're >going, let's just be honest about it and state that it's an economic >issue and be done with it. That, I think, is preferable to producing >junk science like the Hannah study. DP > -- Joanne Bulley, MD Keene, NH, USA "Every gun that is made, every warship launched, every rocket fired, signifies in the final sense a theft from those who hunger and are not fed, those who are cold and are not clothed." President Dwight D. Eisenhower April 16, 1953 Next message: Kpmcl@aol.com: "Re: OB-GYN-L digest 3544" Previous message: Joanne Bulley, MD: "Re: breech"

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