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Re: Cesarean on Demand From: Henry Gregor (henrygregor@yahoo.com) Thu Dec 29 20:04:57 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: DoctorJoe@aol.com: "Re: Not really Kick Counts" Previous message: Henry Gregor: "Re: Not really Kick Counts" In reply to: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Re: Cesarean on Demand" Next in thread: Richard Chudacoff, MD: "Re: Cesarean on Demand" Hasn't been mentioned in this thread these last few submissions, but when ACOG first published an opinion on elective sections a few years ago, Dr. Hale (rightfully I believe) mentioned patient autonomy....given the fact there are medically valid pros and cons in favor of both methods of delivery, I believe the patient's autonomy is to be respected. As for costs to the system,. a scheduled cs is not inherently more expensive than vag delivery, at least in some studies...beyond which, cost - if not excessive and ruinous to the social fiduciary responsiblility of the profession - should not trump patient autonomy...my one and half cents worth tonite, :-) Hanbk "Elrod, Darryl G MAJ 48 MDOS/SGOBO" <Darryl.elrod@LAKENHEATH.AF.MIL> wrote: But unlike plastic surgery, delivery (or birth) of the baby isn't really elective. The mode of delivery is in this case simply a choice. Like any other procedure in medicine there are alternatives presented. Educate the patient and let them decide. Would the insurance company not pay for an open appendectomy because the laparoscopic way is quicker? Glen -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Anna Meenan, MD Sent: Friday, December 30, 2005 1:10 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Cesarean on Demand I'm guessing you would be under no more obligation to do an elective C-sec than you would be to do elective plastic surgery that the state declined to pay for. Anna Meenan, MD At Thu, 29 Dec 2005, Lynn D. Montgomery, M.D. wrote: > >I have an interesting dilemma for y'all. From my understanding, when >confronted by a patient requesting a "cesarean on demand", one has the >option of either abiding by their wishes or "firing" them as a patient and >informing them to find another provider who will comply with their wishes, >knowing that I am responsible for 30 days - which in obstetrics, if they are >near term or in labor, keeps one on the hook. > >Because I have many Medicaid patients, we inquired of the state what their >stand is on payment for "cesarean on demand". Their response was that they >will only pay for "medically indicated" procedures and if there is not a >"valid" reason for a procedure, such as a cesarean section, they will not >reimburse. > >So, if a Medicaid patient requests a "cesarean on demand" and I respond by >saying that I can't/won't because I will not get paid, how does this sit >legally??? >Lynn > >-- >Lynn D. Montgomery, M.D. >Maternal-Fetal Medicine, OB/GYN >Rocky Mountain Women's Health >2835 Fort Missoula Rd., Suite 304 >Missoula, Montana, 59804 >406-549-0978 >fax 406-549-0987 >e-mail: apgar10@montanadsl.net > Find Great Deals on Holiday Gifts at Yahoo! Shopping Next message: DoctorJoe@aol.com: "Re: Not really Kick Counts" Previous message: Henry Gregor: "Re: Not really Kick Counts" In reply to: Elrod, Darryl G MAJ 48 MDOS/SGOBO: "Re: Cesarean on Demand" Next in thread: Richard Chudacoff, MD: "Re: Cesarean on Demand"

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