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Re: casual research questionFrom: Henry Gregor (henrygregor@yahoo.com)Fri Jun 29 16:09:08 2007
I wouldn't think there is "an" answer to the question. I would expect there to be a large number of answers, representative of various times, places, and medical/L&Dstaff/patient group cultural milieus. FWIW, I have seen patient demand as the primary motivator, albeit in small hospitals (except for residency training in which the university structure was "guided" into the process by patient demand....the insured patients with a variety of choices exercised those choices by heading to the private facilities that offered epi's. The university staff responded by supporting the availability of same.) Impetus also seemed to come from L&D staff who didn't sense that unrelieved labor pain was ennobling or affirming of womanhood and wanted their patients to have options.....as well as from some who (perish this suspicious thought) wanted a quiet work environment...and from providers who wanted their patients to have a choice. Lowest on the list, IMO, have been anesthesia services. I think our good friends who provide that care have always done so in the midst of relative "hassles" re disruption of OR schedules, sleep and call schedules and poor reimbursement rates...especially now. We should all appeciate what they do for us. I send these comments not as an "answer", just one snapshot from among many different ones that listers will have had. Hank "westsidebirthservice@juno.com" <westsidebirthservice@juno.com> wrote: So where do you think the epidural craze come from--women/nurses/physicians/society/anesthesiologists? Louana
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