--
Richard Chudacoff, MD
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Andrew
Folley
Sent: Thursday, March 03, 2005 7:46 AM
To: Multiple recipients of list OB-GYN-L
Subject: Re: Induction protocols
Andrew responds:
Thanks for the fedback. It sounds lie we all are seeing and doing more
"elective" inductions. I do not think it is necessarily "bad medicine" but
that it causes some logisitic prolbems and it may drive up health care
costs. Many of our inductions come in the night before and are hospitalized
with cervidil placement until am. I think the cervidil costs the hospital
about $150 and the charge to patient and insurance is about $400 plus the
expense of the extra day in the hospital. Any other thoughts on how we are
doing inductions? Oral cytotec? vaginal cytotec? laminaria ripening?
prostaglandin gel as out patient etc? andrew
>From: islesannie@yahoo.com (Joanne Bulley, MD)
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: Induction protocols
>Date: Wed, 2 Mar 2005 21:55:12 -0600
>
>This sounds like something the chair of the dept would need to hold some
>pow wows on -- rather than declaring the plan. One there is a plan,
>however, then there has to be a dicision on implementation.
>
>In residency with a dept of about 30 OBs ... yes - al iinductions were
>booked with L&D and the log was kept with the reasons etc. We really
>didnt' have many that were the truly elective ones -- and if we got more
>than we were agreed to handle the least urgent w=ones were put off --
>and I would guess that if we had a new policiy that it would be the dept
>chair (or his / her designee) that would be called if some irate doc
>called up demanding that patient Ms Doe be put on and there was either
>no room -- or it was not indicated.
>
>Joanne
>
>At Wed, 02 Mar 2005, Andrew Folley wrote:
> >
> >Dan
> >How does your hospital enforce the policy? ie how far in advance does
>one
> >call to reserve a day for induction. Dioes L and D keep a log? do you
>have
> >strict criteria for inductions to be met? I think our induction rate
> >(medically indicated and "elective" is about 30% which is alarmingly
>high.
> >Andrew
> >
>
>--
>Joanne Bulley, MD
>Keene, NH, USA
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