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Re: VBAC policy, Opinions regarding actions taken by a practitioner, long.From: ainsron@msn.comMon Jan 24 15:05:19 2000
At Mon, 24 Jan 2000, Garry Siegel wrote: > >Ron: Thanks for saying what I've been thinking. I've just had trouble >putting it down on the keyboard--however, I have an aversion to docs >doing procedures for which they don't have privileges. Since VBACs >aren't allowed, then this physician doesn't have the privilege to >perform a VBAC anymore than he does to perform a craniotomy, unless he >has been granted that privilege. Gary: I agree that doctors should not perform procedures that they are not qualified or credentialed for. However, the task of removing a physician's privileges for any procedure he is already performing is more complicated than simply denying new privileges or removing privileges one is no longer using or current in. Medical staff bylaws should not be superceded by the administration's position that VBAC is unsafe as of Y2K. In most institutions, privileges can only be removed for cause, and each individual physician should be given the opportunity to defend his privileges, according to the bylaws. Summary restriction of privileges should be reserved only for cases where the risks are so great as to pose a significant risk to the public. In a case like VBAC, unless the individual has had a recent bad outcome or poorly managed cases, the only thing that has changed is the perception of risk and he has a right to due process. When I was Chief of Staff, I was involved in a case to revoke privileges on another ob who had been an associate. If everything hadn't been above board and followed to the letter of the bylaws, we would have been in deep sh**. I think Dr. Dew's hospital might find that to be the case.
-- Ronald E. Ainsworth, MD
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