Re: ACOG statement
From: Dr Eberhard Lisse (el@lisse.NA)
Wed Nov 29 09:04:28 2006
This is not a community (doctors and midwives alike) list, this is an
obstetricnan and gynaecologist list.
go away, and whine elsewhere.
el
on 11/29/06 4:32 PM Louana George, RN, LM, CPM, MA said the following:
> 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.
--
Dr. Eberhard W. Lisse \ / Obstetrician & Gynaecologist (Saar)
el@lisse.NA el108-ARIN / * | Telephone: +264 81 124 6733 (cell)
PO Box 8421 \ / Please do NOT email to this address
Bachbrecht, Namibia ;____/ if it is DNS related in ANY way
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