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Re: TIC - US OB's beware! From: Braun, R. Daniel (rbraun@iupui.edu) Fri Sep 24 06:23:23 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Joanne Bulley, MD: "Re: TIC - US OB's beware!" Previous message: Garry E. Siegel, M.D.: "GEN: Valued employee" Next in thread: Joanne Bulley, MD: "Re: TIC - US OB's beware!" Reply: Joanne Bulley, MD: "Re: TIC - US OB's beware!" Reply: D. Ashley Hill: "Re: TIC - US OB's beware!" I have seen two of the people trained in these programs. One never wanted privileges for C/S and actually gave up OB 2 years later. The other one got privileges, but never did them and 2 years later gave up OB. Both gave up on OB because they couldn't sdo enough deliveries to pay their Insurance costs. R. Daniel Braun, MD "If everyone likes you, you're doing something wrong." Kinky Friedman I believe a self-righteous liberal or conservative with a cause is more dangerous than a Hell's Angel with an attitude. Andy Rooney -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] Sent: Thursday, September 23, 2004 3:20 PM To: Multiple recipients of list OB-GYN-L Subject: Re: TIC - US OB's beware! .. It might be of some interest to know that there are currently a number of programs in the country now that offer OB fellowships to FP's. They learn to do cesarean deliveries and spend a year (? maybe two ?) doing OB exclusively. (Perhaps some GYN, too, I do not know). Interesting idea. - - - - At 12:24 PM 9/22/2004 -0500, you wrote: Actually, we do have a couple of FP's in our department who are trained to do c-sections, and I'm sure that quite a bit of the backup will fall to them. One is actually a guy who trained in OB in Argentina and decided to become an FP when he came here. Here's the thing, though. Most of the folks delivered through the residency program here are Public Aid patients, those which the local OB's have sort of declined to deliver. We used to have several hospital-based clinics in this town that were staffed by rotating OB's, but over the years, things have pretty much consolidated into the residency program and the local federally-funded clinic for the Underserved. The private docs have pretty much dropped out of the picture, the perinatologists have declined to take on the complete care of any high-risk patients (they will consult only and bounce them right back to the FP's). Basically, we now have HUNDREDS of pts, many of them high-risk (alcoholics, addicts, sicklers, diabetics, hypertensives, etc) being cared for by FP's and FP residents, because no one else will. We have a small group of OB's in the University department who provide our backup, but not enough to provide 24/7 in-house coverage. The hospital is trying to find locum tenens guys for nighttime coverage, but that's not gonna come cheap, and this particular hospital is already shouldering quite a bit of the burden of OB care for the underserved in this town (almost all of it, in fact). And yes Joe, we are continuing to train about one resident a year to do c-sections, Amazingly, not everyone in this country is able to have their baby in a major metropolitan hospital, and with folks dropping OB due to malpractice increases, it's getting even harder to find someone who can do a c-section in rural areas, so these guys (and gals) are filling a need. It would be nice if we could, for instance, tell every woman in Louisiana that she will have to come to New Orleans to have her baby, but then I suspect that we would begin to see an increase in the number of babies born halfway across the causeway over Lake Ponchartrain. Basically, we're not trying to erode anyone's power. We're just stepping in where others have stepped out. If the L&D unit in this particular hospital has to close due to lack of coverage for inductions, it will create a HUGE gap in this town that no one is willing to fill. Anna Meenan, MD, FAAFP At Sat, 18 Sep 2004, DoctorJoe@aol.com wrote: > >Ah, another sneaky conspiracy by FPs to have THEM trained (at the 3rd >year >level) to be able to do C-sections. Another erosion of the OB's power. Next >thing you know, MIDWIVES will have C-section privileges, just to keep JCAHO >accreditation (and ability to collect all that federal money, etc., etc. - Follow >the money.") > >Joe P. Next message: Joanne Bulley, MD: "Re: TIC - US OB's beware!" Previous message: Garry E. Siegel, M.D.: "GEN: Valued employee" Next in thread: Joanne Bulley, MD: "Re: TIC - US OB's beware!" Reply: Joanne Bulley, MD: "Re: TIC - US OB's beware!" Reply: D. Ashley Hill: "Re: TIC - US OB's beware!"

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