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Re: Volume --> ACOG and primary care From: Henry Gregor (henrygregor@yahoo.com) Tue Jun 20 13:30:01 2006 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Richard Chudacoff, MD: "first trimester screening consent" Previous message: Henry Gregor: "Re: Burying the ultrasound unit" In reply to: DoctorJoe@aol.com: "Re: Volume --> ACOG and primary care" Joe, You've got a great talent for analysis and presentation. Hank DoctorJoe@aol.com wrote: In a message dated 6/19/06 9:30:36 AM, l.glazerman@rcn.com writes: It’s because our College, in their ultimate wisdom, decided (incorrectly) that primary care is where the money is, and sold us out. My perception, as the whole "argument" carried on, was that is was . . . yeah, you said it . . . simply a money thing. Historically speaking: First the dinosaurs came. Then they died and made oil. Fast forward to insurance companies who ordained that we (THEY) were spending too much on healthcare. This brought about the concept of a "gate keeper" which was usually a primary care doc who had to refer patients to specialists. Specialists (then) included OB-GYNs. The "gate keeper" could cut down on medical expenses by keeping the expensive specialists out of the picture for as long as possible. Well, a primary care doc, as we all know, CAN do Pap smears, breast exams, etc., etc. Soooooo, the old yearly GYN exam and all that flows from it were suddenly being taken away from GYNs because they were "specialists," not primary care people. The ACOG went on the hunt to have GYNs declared primary care docs. (Even though the GYNs in the trenches did NOT want the responsibility of taking care of women's primary care - they just wanted their measly yearly exam and Pap smear.) ACOG did NOT want to lose the Pap smear and yearly exam!!! Well, they got what they wanted. NOW GYN is a "primary care" or "office-based" discipline (to many) and so we need high-falutin' GYN ONC or GYN UROL just to do routine surgeries that once all GYNs could do in their sleep. And the fellowships take the surgeries away from the residents, who do less, yada, yada, yada. [Not to mention MFM, who takes the high-risk OB away, and in the US, ALL OB is "high risk," right? Since we don't let midwives take care of them out in the rice fields. But that's a story for yet another day. LOL] So for ACOG, it's yet another case of "be careful what you ask for." They've effectively split the "specialty" into general office docs who can do Pap smears with the best of them (or the worst of them) and the supersurgeons who can do surgeries like, well, like GYNs used to do in the old days anyway. But I guess they can charge more or something. Hi-ho. Joe P. Next message: Richard Chudacoff, MD: "first trimester screening consent" Previous message: Henry Gregor: "Re: Burying the ultrasound unit" In reply to: DoctorJoe@aol.com: "Re: Volume --> ACOG and primary care"

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