Re: ACOG statement
From: Louana George, RN, LM, CPM, MA (westsidebirthservice@juno.com)
Wed Nov 29 08:31:21 2006
little revolutionary speech here and a radical thought---
Instead of attacking such a small group of health care providers, the
midwives, it would serve the community (doctors and midwives alike)
better if ACOG had taken a stand against malpractice claims, malpractice
insurers, and health insurance companies. A lot of the talk here has
been about insurance companies. Medicine seems to me to be a strong and
cohesive community--I think (humble opinion) that could be used to
negotiate better terms in the above areas.
Louana
At Wed, 29 Nov 2006, Barbara Nicol wrote:
>
>> What ... an ad rem argument? No ad hominem attack? Where's the fun in
>> that?
>>
>> /sarc
>>
>> Art
>>
>Yeah, I know - not up to the list's usual standard. (Hangs head in shame.)
>
>Just to prove that I have no sense of humor, I will make one minor
>correction to my own post - my WA stint was 96-02, not 02-06. It
>doesn't affect the point I was trying to make, though - actually, it was
>during the period of the study. Wasn't backing up OOH births then either,
>but saw some transfers in up there as well.
>
>My experience is that the OOH birth is just a reality of practicing
>obstetrics in this part of the world. You can't act as a consultant or
>backup, of course, but when the patient walks into your L&D unit as an
>emergency transfer of care (usually because her midwife told her it was
>necessary) you get on better if you treat her and the referring midwife with
>respect, and glean all the information you can from the outside records.
>My experience is that encouraging the midwife to stay around in the role of
>supportive visitor aka doula is frequently helpful in building trust; it's
>much easier to get consent to a CS, for example, if the trusted support
>person is sitting there nodding her head. Even if she's not nodding her
>head, it's better to have the discussions in person rather than have the
>patient on the cellphone with her midwife every 10 minutes and relaying a
>bunch of questions whose answers would be completely apparent if she were
>just in the room. Of course, there are memorable exceptions; well, to be
>fair, there are difficult personalities on the MD side as well. But the
>majority of OOH providers are pretty reasonable people.
>
>90 percent of us get sued. It's an unbelievably awful experience even when
>you did nothing wrong, and it's worse when there's some real question on
>that point. I admit to a lot of frustration and upset when an obvious
>litogen (e.g. local favorite: refusing GBS prophy because 'antibiotics cause
>asthma', don't get me started on this nightmare of junk science) walks
>through the door, but communicating those emotions to the patient just
>starts things off on the wrong foot altogether, as I'm sure y'all know
>already.
>
>- Barb Nicol, M.D., F.A.C.O.G.
|
|
