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Re: Signatures From: ainsron (ainsron@sbcglobal.net) Tue Aug 7 19:10:29 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Larry Glazerman: "Re: Vaginal Birth after uterine perforation?" Previous message: ainsron: "Re: Vaginal Birth after uterine perforation?" In reply to: Efrain Ramirez: "Re: Signatures" According to Medicare and Medicaid guidelines, I am ultimately the one responsible. That doesn't mean I have to micromanage their care and look over their shoulder. They are subject to the same hospital reviews as physician and as a perinatal committee, we look at their complications just as we look at their own. Signing everything they sign does not mean I've read everything, it just means I've signed it. We all use the same intrapartum and postpartum orders, we all use the same nursing protocols for preterm labor, 3rd stage, etc. The important process to me is approving their protocols and orders that they can write and then responding to situations that are out of their scope of practice. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Efrain Ramirez Sent: Tuesday, August 07, 2007 4:57 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Signatures Who is legally responsible? Ef >At Tue, 7 Aug 2007, ainsron wrote: > >I agree with you, it is very counterproductive. I'm trying to get it >changed at my end and looking for evidence to support that it is not a >universal requirement, just a local interpretation. > >Ronald E. Ainsworth, MD, FACOG > >-----Original Message----- >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. >Siegel, M.D. >Sent: Monday, August 06, 2007 7:53 PM >To: Multiple recipients of list OB-GYN-L >Subject: Re: Signatures > >We countersign every note and order of our CNMs, and it is a waste of >time, and done after the fact most often. > >Garry > >At Mon, 6 Aug 2007, Dr. Ainsworth wrote: >> >>I have a question for any of you MDs who back up midwives or for >>midwives who practice in the hospital. >> >>Are MD signatures required on every order written in your hospital by >>CNMs? It is a requirement in my hospital, a requirement by the medical >>staff bylaws. However, I can't find that to be a requirement of the CMS >>interpretive guidelines. As far as I am concerned, I think it is a >>waste of my time. The only orders I should have to sign are those >>outside of the scope of practice on the CNM or not covered by the >>medical staff approved protocols for hospital care. > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- " The greatest obstacle to knowledge is not ignorance, it is the illusion of knowledge." Daniel J. Boorstin - Historian Next message: Larry Glazerman: "Re: Vaginal Birth after uterine perforation?" Previous message: ainsron: "Re: Vaginal Birth after uterine perforation?" In reply to: Efrain Ramirez: "Re: Signatures"

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