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What patients think, was Re: Postdates,Neonatal Death (long)From: Garry E. Siegel, M.D. (garrys@mindspring.com)Wed Aug 3 21:24:05 2005
At Wed, 3 Aug 2005, Len2976@aol.com wrote: > >Anna-- > >You wonder how they will raise teenagers? I can tell you--to be just like >themselves. Take 2 recent episodes in our practice: > >#1. A 16 y/o was scheduled for an elective IOL at 39 weeks. The patient >and mother insisted she could not handle it any more, and the obstetrician >scheduled her for cytotec ripening. The day she was to come in L&D was busy and >they called to tell her that the elective had to be postponed till the next >day. The patient's mother screamed at the nurse, swore, and threatened to >either "call her attorney" or take her to another. After I assured her another >hospital would not induce her without a medical indication that evening, she >reluctantly accepted the postponement. > Lenora's study above reminds me of one case my practice had, both of which highlight "what patients think." A few years ago, one of my partners had a Monday AM 7:30 section for a younger patient--probably a repeat on a rural, 20-23-ish patient with the mother nearby. About 7 AM, my partner called with a bug such that she couldn't get her head off of the pillow. I had the joy of telling the family at 7:30 or so that her section was going to be cancelled and rescheduled until tomorrow, so sorry for the inconvenience/trouble, yada, as I truly know and understand that your life/family/etc. have all been arranged for a delivery today. Mom was rather pissed, and asked me (it's now around 8:15, and I have office in 15 minutes) "Isn't there another doctor who can do it?" Um, well, not really, and maybe you're TALKING to a doctor who might be able to do so. My point is that, over the years, many patients and their families who tend to be (IMHO) a bit less educated/less advantaged demographically seem to assume things like: 1. It's OK to go to any hospital any time for care, irrespective of the degree of acuity. 2. There's not a need to call your doctor first. 3. If your doctor is busy, etc., well, no problem, find another one. Just had on show up at the wrong hospital to deliver after being sent from our office to hospital A. She showed up at hospital B, unbeknownst to us, where we're on staff. 4. Doctors and hospitals are open and ready 24/7. Since I've had no prenatal care and just dropped in at 7 PM on a Tuesday, can a doctor see me/do and ultrasound, and, by the way, I don't have insurance. I could go on and on, of course. Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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