Re: VBAC question
From: Andrew Folley (agfolley@hotmail.com)
Wed May 16 17:15:51 2007
Pretty standard that you have to be on campus or have an OB provider on
campus who is willing to respond to ruptured VBAC. It is a legal issue of
what it meaans to be "on campus" not a practical issue of when you can get
there. You can fight it but you are in a bad position. Either stop your
VBACS or hire one of the in campus groups to be available for you in the
event of an emergency for a nominal fee?????????
PS what happens after hours??? Do you routinely stay at hospital with your
VBAC in labor?
>From: "Lynn Montgomery" <apgar10@thebirthcentermt.com>
>Reply-To: ob-gyn-l@obgyn.net
>To: Multiple recipients of list OB-GYN-L <ob-gyn-l@dns.obgyn.net>
>Subject: VBAC question
>Date: Wed, 16 May 2007 11:05:41 -0500
>
>Listers,
>
>I have a question for you. Our new clinic is approximately 6 blocks
>from the only hospital in town that does obstetrics. We are the only
>obstetric provider "off campus". However, prior to moving into our new
>clinic, my office was on the third floor of an office building "on
>campus" but across a large parking lot from the hospital - a situation
>shared by many other obstetric providers. When we moved into the new
>office, the first ten times I was called to L&D, I actually timed myself
>and the time it took me to get from the new office equaled the time from
>my old office "on campus" - sometimes even quicker.
>
>Last week our practice got called by the medical director of obstetrics
>informing us that the hospital med-mal policy stated that when a VBAC is
>in labor at the hospital, the obstetric provider must be "on campus",
>thus requiring only our group to leave our office and sit on L&D with a
>VBAC in labor - we currently do more deliveries than any of the other
>groups in town. I have several points of contention here:
>
>-First, I rather doubt that any insurance carrier came to our facility,
>looked around and decided to mandate that a physician be required to be
>"on campus". I could see the policy adopting a policy similar to ACOG
>of "immediately available" or maybe even, "in the hospital", but not a
>random "on campus". I am requesting a copy of the insurance policy to
>review the wording.
>
>-Second, six of the obstetric providers are 60 years old or greater and
>to randomly state that they can be "on campus", as opposed to me being 6
>blocks away doesn't consider the fact that I can beat them walking from
>my place.
>
>-It would seem more appropriate in this circumstance for the hospital to
>simply adopt a no VBAC policy rather than create divisions within a
>section.
>
>Comments please.
>
>Lynn
>
>Lynn D. Montgomery, M.D.
>
>Obstetrics & Gynecology, Maternal-Fetal Medicine
>
>The Birth Center/Rocky Mountain Women's Health
>
>1211 S. Reserve St.
>
>Missoula, Montana, 59801
>
>406-549-0978
>
>fax 406-549-0987
>
>e-mail: apgar10@thebirthcentermt.com
>
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