Re: Coulter, Malpractice & Edwards (long)
From: Harrison Sheld (hsheld@anv.net)
Sun Jul 11 18:45:45 2004
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Exactly!
Is this not reminscent of the abused spouse? If we just have the right
kind of evaluation, if we just don't use the wrong abbreviations, if we
just disavow pharmaceutical support, if we just limit the residents'
work hours, if we just have CME in the angst du jour, if this feel-good,
sound-good (you fill in the blank) is followed, then they will not hit
on us, then there will be no unhappiness with our care and they will
like us. and they will leave us alone.
It is ironic that on the one hand, we are asked to use evidence-based
and peer reviewed data in our practices, but on the other hand, there
are no data showing that to correctly fill in 120 of 180 little black
circles on an answer sheet on an examination, to sit through 50 hours of
CME per given unit of time, to attend "the right kind of" annual medical
meetings, and in fact to follow JCAHO guidelines, any of these "helps"
will make for better patient care. Look at the result of what has
already been mandated after all the alleged "improvements" in the
delivery of medical care that have been instituted and enacted in the
last 20 years. Where are we? We're told that things have gotten worse.
Regularly, we seem to read reports from institutions of no little
repute of the wrong blood matched, wrong organs transplanted,
cardiovascular surgery errors, etc. In medicine, when a therapy doesn't
work, common sense dictates that we change it. Instead we seem to be
getting more regulated not less with "therapies" that have not been
proven. A "pilot study" of selected physicians knowing what they are
being asked to show, trying out "good ideas", will not likely supply
data as robust and rigorous as data from the levels of evidence
required by today's peer-reviewed journals in order to improve the
medical care we give.
Now we are struggling with making the system go, on a daily basis,
suffering the slings and arrows from lawyers, third party payers, and
government regulations. These are the suffocating "burdens of practice."
We need relief. Please tell me that the idea of helping us from the ACOG
and ABOG is not to mosey on down the "Road to Maintaining Excellence."
Gerald P. Rodríguez wrote:
> Along the same line, Harrison, is the ACOG "Today" glossy news
> publication, July 2004, that features Vivian Dickerson at her
> inaugural address as the new President, urging all ACOG members to
> embrace her "Women's Health Bill of Rights." Now, no one would argue
> that the 10 listed rights should not be part of every OB-GYN's credo.
> How can one argue against, e.g., being for "Socioeconomic and
> Political Equality" for women. But is all a lot of "feel good" pap.
> Nowhere, evidently, in her inaugural address was there more than a nod
> re the issues of tort reform and professional liability.
>
> In the very same issue, buried in one of the back pages (p. 9), is a
> small piece reporting that the percentage of ob-gyn residency slots
> filled by U.S. medical school seniors this year was down to 65%, down
> from 75% in 2000, 2001, & 2002, and down from 68% in 2003. Are we
> dying on the vine, or what?
>
> <<Plaintiff attorneys like John
> Edwards are not the people who go into court and testify that standards
> of care were not met.>>
>
> And in most cases of CP, the whores who testify against the defendant
> Ob-Gyn are being paid a lot less than the whores who represent the
> plaintiff. J. Edwards may be, in some eyes, "for the little guy," but
> his $800M is ill-begotten.
>
> Gerald P. Rodríguez, M.D., FACOG
> Santa Fe
>
>> ----- Original Message -----
> From: Harrison Sheld <mailto:hsheld@anv.net>
> To: Multiple recipients of list OB-GYN-L
> <mailto:ob-gyn-l@dns.obgyn.net>
> Sent: Sunday, July 11, 2004 11:43 AM
> Subject: Re: Coulter, Malpractice & Edwards
>
> Points well taken. The editorialists in July Contemporary OB/GYN
> are worried about OTC Plan B while trial lawyers want to rip our
> hearts out with their bare hands. On the other hand, in this
> month's Green Journal, ACOG and ABOG want to maintain excellence
> suggesting some more hoops to jump through for credentialing. How
> many state boards now want proof of CME in Bioterrorism, End of
> Life Care, Ethics, and whatever. Next it will be table manners.
> And then, and this is the kicker, we are asked why there are a
> declining number of med school applicants, and fewer physicians
> are going into OB/GYN. Golly gee, I don't know. Maybe some of our
> colleagues will wise up when the yearly Compendium of Selected
> Publications is replaced with the Federal Register.
>
> Don Miller wrote:
>
>>>Personally, I'd prefer keeping such vitriol spewing columnists like Ann
>>>Coulter off the list.
>>>
>>
>>>I second the motion that we refrain from quoting miscreants
>>>
>>
>>Personally, I'd prefer that we denounce those on the list who would try
>>to impose their own political "filters" on what should or should not be
>>posted here. And why is it always those who are the most "liberal", are
>>the ones who are most intolerant of opposing views and are so quick to
>>name-calling?
>>
>>>In the hope of getting this conversation back onto the issue at hand
>>>
>>
>>The issue "at hand" is tort/malpractice reform and NOT which candidate
>>is most eloquent. I hope that you agree that the progress of
>>tort/malpractice reform in the USA directly affects, every day, the
>>livelihood and career choices of many on this list. Physicians should
>>be allowed to inform themselves of ALL views on such issues and make
>>their own decisions - and then live with the consequences of those
>>decisions.
>>
>>As I first said, it is a certainty, that with a trial lawyer who has
>>made millions suing doctors (primarily obstetricians) in the White House
>>(e.g. a fox in the henhouse), that tort reform would be DEAD for years.
>>I just hope that trial lawyers don't try to "get back" at physicians
>>like they did to the docs in Florida who sought to limit trial lawyer
>>fees.
>>
>>BTW, I like how you have decided that physicians are the real source of
>>the malpractice crisis. I'm sure Edwards and the trial lawyers' lobby
>>would agree with you.
>>
>>--
>>Donald W. Miller, Jr., MD, FACOG
>>eNATAL, LLC
>>http://www.eNATAL.com
>>
