Re: Evaluation of OB Patients
From: art fougner, md (evsono@pipeline.com)
Thu Nov 22 18:18:02 2007
This just in:
Hippocratic Oath 'Under Review' By HMO Board
INDIANAPOLIS—In a development bioethicists and health-care industry
professionals are watching closely, the board of directors of Indiana
HMO PhysCare-Plus, one of the largest and most powerful HMOs in the
nation, announced Monday that the Hippocratic Oath is currently "under
review."
http://www.theonion.com/content/node/29112
Onion Alert ... but the way things are going, it could happen.
Art
At Thu, 22 Nov 2007, R. Daniel Braun wrote:
>
>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
>
--
art fougner, md
"May The Wings of Liberty Never Lose a Feather." - Jack Burton
