Re: Collaborative practice - was Grande Multip

From: Barbara Nicol (blnicol@ix.netcom.com)
Mon May 1 17:03:30 2006


In general, our practice (6 CNM, 3 MD) sees induction as enough of a deviation from normal that it should be discussed first. But then, I work in a setting with a low induction rate and very few social inductions. Most of the inductions therefore merit discussion with an MD anyway because they are not, strictly speaking, low-risk. I think having to discuss it with someone else cuts down the chance of unnecessary intervention.

In a setting in which social inductions or elective term inductions are common, one might understand if the CNM and MDs had come to an agreement that certain types of social or even indicated inductions (e.g. term multipara with favorable cervix, postdates) could be scheduled without additional consultation. So, yeah, our protocols require consultation prior to induction - but I could imagine a setting in which consultation wasn't required under certain circumstances. (The CNMs wrote the protocols, btw, though the MDs are involved in the final revisions each time.)

Hope that helps!

- Barb Nicol

-----Original Message----- >From: "Garry E. Siegel, M.D." <garrys@mindspring.com>
>Sent: May 1, 2006 5:36 PM
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: Re: Collaborative practice - was Grande Multip
>
>You are quite perceptive regarding this case.
>
>For those with CNM/collaborative practice, do you always ask for an
>induction to be "cleared" with an MD first?
>
>Garry
>





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