Re: Evaluation of OB Patients
From: R. Daniel Braun (rd.braun@gmail.com)
Thu Nov 22 17:04:26 2007
I totally concur with Gordon, but Joe is right too. When every woman who
comes into the ER with abdominal pain gets a CT scan prior to being seen by
the Doc, Something ain't right and we have failed our trainees and hence
their patients.
Dan
On Nov 22, 2007 4:02 PM, Gordon Goldman <obgyndoc@swbell.net> wrote:
> Joe,
> I do not disagree that technology has outstripped most of us being able to
> understand much of it, but I disagree that care is not better than it was 30
> years ago. I think the care of diabetics, care of MHD infants with
> surfactants, care for the infertile couple to become pregnant, to mention a
> few, are all significant improvements in care. Yes, it was technology that
> made them possible, but better care is the bottom line.
>
> Gordon
>
> On Nov 22, 2007, at 2:39 PM, Joe wrote:
>
> Gordon: Lets not confuse care with technology. Interesting conversation we
> are having. As an observation, when you go to our national meeting and 40%
> of the booth are about skin care , I would suggest it ain't worth it. Joe C
>
> Gordon Goldman wrote:
>
> Joe,
> Well, you may be right with regard to the useless persons and paperwork
> industry, but I think the care is far superior to 30 years ago. The
> question I would pose, is (was) it worth the price we (both as physicians
> and society) has paid? I agree there is far too much CYA for the benefit
> derived.
> Gordon M. Goldman, M.D., FACOG
> Private Practice, St. Louis, Mo.
> On Nov 22, 2007, at 8:36 AM, Joe wrote:
>
> Gordon: No , not either of those. Its "Quality Assurance" which we
> willingly created and support , and which has generated a whole new industry
> of useless persons and truck loads of paper. I am not convinced that the
> care ones receives today is better than it was 30 years ago. Have a nice
> Thanksgiving everyone. Joe C
>
> Gordon Goldman wrote:
>
> COBRA or EMTALA?
> Gordon On Nov 21, 2007, at 8:33 PM, Garry E. Siegel, M.D. wrote:
>
> For lots of reasons, some political, some practical, anyone over 20
> weeks (declared or actual) goes to L and D. That said, the ER MDs and
> triage nurses do have discretion and common sense available to them, so
> that someone at 22 weeks who needs obvious ER care (extremity
> care/sprain, laceration) is handled there and THEN sent to L and D for
> monitoring, etc. The perceived problem is in the law (COBRA, I think)
> that says in the small print that anyone needs a labor assessment. When
> I last looked at this as part of the hospital committee, it was not
> clear at what gestational age. Obviously, someone 8 weeks doesn't need
> a fetal monitor, and while 24 weeks made obstetric sense, some of the ER
> docs wanted 16--so we settled on 20! We also ask the ER MD to call the
> Ob doc, unless they want to hear directly from the L and D nurse who
> acts on our (or their) behalf.
>
> Garry
>
> At Wed, 21 Nov 2007, JSBowpat@aol.com <mailto:JSBowpat@aol.com<JSBowpat@aol.com>>
> wrote:
>
> Not at our hospital .... they go directly to OB.\
>
> Susan Paterson CNM
> WI
>
> --
> Garry E. Siegel, M.D.
> Private Practice
> Roswell, GA
>
--
R. Daniel Braun, MD FACOG(L) CMT
Professor Emeritus
Dept. of Obstetrics and Gynecology
Indiana U. School of Medicine
R. Daniel Braun
"Science without Religion is LAME; Religion without Science is BLIND"
Einstein 1941
