Re: Standing Room Only- triage strategies
From: Myer S. Bornstein (mborn@massmed.org)
Thu Oct 6 21:35:33 2005
Anne
The patients like this time so they can recuperate without having to deal
with all the house work etc. Be4sides they do not eat bon-bons now they eat
chocolate cigars :-), at least that is what they gage to me after the
deliveries
Myer
--
Myer S. Bornstein, MD, MMM, FACOG, FACPE
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Anna
Meenan, MD
Sent: Thursday, October 06, 2005 10:03 PM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Standing Room Only- triage strategies
Oh, I understand the problem. I just object to Myer's characterization
of post-op women as "taking advantage' of a four-day stay, like they are
laying around post-partum like princesses, eating bon-bons.
Anna Meenan, MD
At Thu, 06 Oct 2005, rmodugno@aol.com wrote:
>
>Anna, as someone who would want their epidural in the parking lot and who
spent a full week in the hospital recovering from inguinal hernia surgery at
the tender age of 18 - I sympathize with you . The real problem is bed
occupancy. When the managed care companies kicked sections out at 48hours -
there was no problem. With increasing section rates, postpartum is full and
it bottlenecks all the way back through L&D converting our LDR's into LDRP's
and preventing us from bringing in our elective inductions! ;+)
>
>Robert Modugno MD MBA FACOG
>Marietta, GA
>
>-----Original Message-----
>From: Anna Meenan, MD <annam@uic.edu>
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Sent: Thu, 6 Oct 2005 12:29:50 -0500
>Subject: Re: Standing Room Only- triage strategies
>
>Gee, a woman with a fresh abdominal incision who may have spent the
>previous 12-24 hours contracting every 3 minutes with no sleep is
>"taking advantage" of a 4-day recuperation. Most of our pts go home on
>the third day after a c-section, but I still remember being kept 7 days
>after an emergency oophorectomy when I was 21, and I barely felt ready
>to go home then (and i didn't have a baby who was going to wake me every
>three hours once I got home).
>
>--
> Anna Meenan, MD
>
>At Thu, 6 Oct 2005, Myer S. Bornstein wrote:
>>
>>State law mandates 4 day stay after C/Section and patients take advantage
of
>>this.
>>Myer
>>
>>--
>>Myer S. Bornstein, MD, MMM, FACOG, FACPE
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod
>>Darryl G MAJ 48 MDOS/SGOBO
>>Sent: Thursday, October 06, 2005 3:10 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: Standing Room Only- triage strategies
>>
>>I'm only curious why you say that elective c/s stay longer? I can't
>>tell you the last time an elective c/s of mine didn't go home 48 hours
>>after the baby was born. Without labor prerequisite, the composite time
>>in the hospital has been less.
>>
>>Just my thoughts
>>
>>Glen
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of JD
>>Stewart,MD
>>Sent: Wednesday, October 05, 2005 8:09 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Standing Room Only- triage strategies
>>
>>Facing an acute bed shortage in L&D/ postpartum/ nursery and postop GYN
>>surgery all at the same time due to hospital remodeling. Figure this
>>has come up everywhere at one time or another, and I was curious as to
>>the ways this may have worked out...Elective induction rate now >50%;
>><2% VBAC's in state, so repeat C/S rate is way up (with longer
>>stays)..and most of the groups here now no longer throw all the OB
>>delivery income into a common pool, but link it to the delivering
>>partner- so the motivation to electively admit and deliver on "Dr X's
>>hospital day" is tremendous.
>>
>>Push has come to shove, and we are now facing the "medical ante-up" game
>>for line jumping on the induction list. ("..38 weeks plus Short
>>stature/small feet...and her sister had an emergency C/S and is
>>worried.." )
>>
>>Wondering if anyone faced with this has a handy common sense priority
>>strategy they might share...
>>
>>--
>>JD. Stewart, MD
>>MFM up too late all night, every night
>>
