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Re: Family practice and OB From: Glen Elrod (dr99645@yahoo.com) Sun Dec 30 17:53:36 2007 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Ginny Lee: "Re: Difficult Case Microcephaly" Previous message: Glen Elrod: "Re: Family practice and OB" Maybe in reply to: Glen Elrod: "Family practice and OB" Anna, Thanks for the input. I would love to have a copy of that protocol. I developed something similar when I was here at the base three years ago and FP was doing OB, but since it was a fairly tight community with FP offices right next to OB it never was hard to start the communication. I just feel like I've been dropped in a lawless society when it comes to who does what in labor. I'll take that list to our OB subcommittee and work from there. Thanks Glen >----- Original Message ---- From: "Anna Meenan, MD" <annam@uic.edu> To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net> Sent: Sunday, December 30, 2007 10:50:30 AM Subject: Re: Family practice and OB I have been trying to get around to replying to this one, since I am the only FP on the list that I know of. I have a unique situation at the moment, in that I teach FP residents and we have a group of university OB's that we consult with. There is always one of them on call, so it's not a problem. The OB and FP departments (two separate departments in our hospital) got together and agreed on a list of things where consultation is mandatory, including some where the case should be turned over to the OB. If you want a copy of the list I can probably scan it and send it to you as a pdf file sometime when I'm just sitting on L&D. In general, we don't call the OB and tell them a pt needs a c-section. We call them, present the case, and ask them for their input. What happens next kind of depends on who the consultant is, since some are more comfortable with forceps than others (though I don't think we have anyone who still does rotations anymore). They do have the option of recommending things like continuing pitocin longer, therapeutic rest, etc and we go along with what they advise. There is an in-house OB at night for crashing emergencies, but they do not do routine consults. In general, the FP's send their gyne stuff to the OB's who back them up and everyone gets along pretty well. I have a friend who practices in Northern Wisconsin who relies on a general surgeon to do her c-sections, and he says that when she calls, he doesn't want details, just wants to know how fast he needs to drive. So I guess it depends on where you practice. I would recommend you discuss it with the other OB's and find out how everyone else feels about the situation. Getting both departments together and establishing some guidelines would probably be a good idea. -- Anna L. Meenan, MD At Fri, 28 Dec 2007, Glen Elrod wrote: > >Greetings all! I have been away while separating from the service and moving back to Alaska to start a private practice. So far so good, but one thing I've run across at our hospital is with regards to Family Practice and OB. > >We have several FP docs that are doing OB. We even have one that is credentialled for c-sections. I'm OK with that bit, mostly. What I have found out is that the FP docs do not have any set OB doc backup that they use/consult/etc. When the time rolls around that a patient of theirs needs a c/s, they simply call the EMTALA OB call doc and ask them to 'do a c/s' > >My question to the group is, is that standard of care across the country? Is that what EMTALA call is meant for? If I were to try and make a change, what sort of legal legal (Joe) do I have to justify them picking an OB and consulting them. > >Its good to be back. > >Glen > >D. Glen Elrod, MD >Obstetrician/Gynecologist >Sleeping Lady Women's Health Care, LLC > Next message: Ginny Lee: "Re: Difficult Case Microcephaly" Previous message: Glen Elrod: "Re: Family practice and OB" Maybe in reply to: Glen Elrod: "Family practice and OB"

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