Re: VBAC Revisited
From: art fougner, md (evsono@pipeline.com)
Wed Jul 4 16:36:44 2001
At Wed, 04 Jul 2001, Dean Huffman wrote:
>when ACOG made Bill Cosby an honorary fellow, the organization dropped the ball. they could easily have persuaded him to do a serious episode or two in which the good Dr. Huxtable got sued. Especially poignant would have been the fact that his wife was an attorney. would have been wonderful media attention drawn to the plight of good docs in an atrocious system in which the only way a patient can be compensated for a bad outcome is to seek redress in court. emmy material for sure. opportunity wasted. pity.
art
>..
>
>This reminds me of one of the best speeches I ever heard. It was at an APGO
>meeting and the speeker was, I believe, given by Norman F. Gant, M.D.
>Anyway, the thesis of his discussion was that obstetricians are their own
>worst enemy because, by lowering the materna and perinatal mortality rates
>so well, and cutting down on serious complications, the public has come to
>expect perfection, an unrealistic goal.
>
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>Re: VBAC Revisited
>From: Paul Prior MD (pprior@clover.net)
>Wed, 04 Jul 2001 10:57:13 -0400
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>On Wed, 4 Jul 2001 08:57:45 -0500, "Myer Bornstein" <mborn@massmed.org> wrote:
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> >Joe is being facetious in his reply but the courtroom scenario isn't in
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> >this day and age. I have been encouraging all my patience that have had
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> >previous cesarean sections and that were eligible to undergo a VBAC to
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> >try, and have had about a 70 percent success rate. We have trained on
> >labor room nurses to scrub so we have people immediately available to do
> >a section in case of a catastrophe. When there is a VBAC in labor, the
> >obstetrician and the anesthesiologist are in-house. However, with this
> >article and the editorial scientific knowledge is pushed to the
> >background because of lawyers.
> >
> >My wife is a visiting nurse; one of the patience that she saw yesterday
> >had a cesarean section. The patient developed a hematoma in the wound.
> >It was drained and is being packed to allow healing. The patient's
> >mother, who is a nurse, told the patient that they are to see a lawyer
> >because she had a complication.
>
>A local paper ran a front page headline article about a general surgeon who
>had multiple complaints filed against him. As you read the article it
>detailed in laypersons terms several people who had had wound breakdown
>after colon surgery. They lamented about the horrible care that this
>surgeon was providing and sensationalized the fact that these wounds were
>"breaking open" and made it quite clear that this MUST represent some sort
>of malpractice.
>
>Totally biased reporting, showing a total lack of understanding about the
>incidence of expected wound infection after contaminated surgery such as
>colon resections. So it's not just the stinking lawyers, the whole society
>is not only ignorant, but like one big lynch mob out there, ready to pounce
>on the slightest less-than-ideal outcome.
>
>I almost wish we could return to the days when maternal mortality rates
>were 1-2%, infant mortality was much higher, and surgery invariably killed
>people. Maybe people might have a little more perspective then instead of
>freaking out over an expected outcome from a dirty surgery. The poor
>general surgeon (I didn't know him) is just like that one zebra running in
>the pack that gets picked out by the lions. We are those other zebras and
>we just keep running and hoping it's someone else, but sooner or later....
>
>--
>
>Paul Prior MD They that can give up essential liberty to obtain a little
>Coshocton, OH temporary safety deserve neither liberty nor safety.
>Solo Practice - Benjamin Franklin, 1759.
>OB/GYN, FACOG
>
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--
art fougner, md
A series of 1000 cases begins with but a single anecdote.
