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assistants at CesareanFrom: Douglas Krell (sfth@roadrunner.com)Wed Aug 7 07:58:29 1996
> Dear Listmembers, > > Thanks for your tremendous response to my question regarding assistants > at Cesarean Section! > > To summarize: > > It seems that most people recognize the need for trained assistants > whether they be physicians, CNM's, or surgical technicians. > > Most people seem to feel that these assistants deserve payment in some > form. > > For an insurance company to completely deny payment for a surgical > assistant at Cesarean section is simply an example of the degree of > control which they now feel they can exercise upon us. The fact that > some institutions and their professional staff have found it economical > to use alternatives to a second physician shows how willing we've been > to help hold down costs and manage resources. Yet our efforts are met > with ever increasingly outrageous demands. > > I know for a certainty, that if my daughter or wife was having a > Cesarean, I would want a trained assistant present whose attention was > completely focused on the job at hand. That is the ideal. That we do > not strive or stand up for that ideal is what seems somehow immoral to > me, particularly as insurance company CEO's siphon off hundreds of > millions of health care dollars dollars into a handful of exective > pockets. I pity the poor CNM who was expected to 1st assist at > C-sections without reimbursement. > > Personally, I've spent most of my career in Indian Health, Public > Health, staff-model HMO, and now recently private practice. Over the > years I've had everyone from the cleaning lady...on up to assist me with C-sections. So it's not that I've become used to the posh life in private practice, but rather that I've experienced a spectrum of > training and competence for C-section assistants that has left me with > the impression that more is better. > > Finally, the fact that there are plenty of C-sections that would go > smoothly without an assistant is not the issue. How many of you > traveling in snowy winter climes toss an extra blanket and shovel into > the trunk of your car? It's not the expense of those items as much as > the expense incurred if the item was needed, but not at hand. If we do not expect that surgical assistants be paid, soon enough, insurance companies will expect us to pay them out of our own pocket.
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