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Re: vbac on demand From: Dr Eberhard W Lisse (el@lisse.na) Wed May 14 13:04:27 2008 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: l.glazerman@rcn.com: "Re: Are there programs just for electronic" Previous message: Dr Eberhard W Lisse: "Re: vbac on demand" In reply to: Lynn Montgomery: "Re: vbac on demand" Next in thread: Efrain Ramirez: "Re: vbac on demand" Reply: Efrain Ramirez: "Re: vbac on demand" Lynn, the statute reads to me, that if a patient refuses treatment she is not covered by EMTALA any more. I am not saying or have ever said that that one should even contemplate forcing surgery. I am also not saying that an "own" doctor should abandon her. The way I read EMTALA is that someone who does *not* have an "own" physician can not be dumped, unless, and that I still maintain, unless she refuses treatment, which is reasonable as in this case, an ACOG recommendation. The statute says hospital, not physician, and I am not sure, emergency treatment under the statute without payment establishes a doctor-patient relationship. But, the idea can not be to use this statute to force an obstetrician to perform a VABC against his wishes on a patient he's never seen before. el On May 14, 2008, at 17:12, Lynn Montgomery wrote: > EL, > Unfortunately, in the US, most hospitals have call schedules that all > obstetricians with privileges are required to participate in call > "town > call" or "no-doc call", etc. When you are on that call, you are > required to care for any patients who happen to drop into the hospital > and don't have a physician with privileges at that hospital. If that > patient is in "labor", EMTALA strictly prohibits transport of a > "laboring patient". Here in Missoula, we only have one hospital that > provides obstetrics and I get saddled with this type of patient all > the > time. If a patient with a previous cesarean section presented in this > circumstance and refused repeat cesarean, other than providing > informed > consent, I would be stuck to abide by her wishes, unless of course I > could get another physician to take care of her, which would not > happen. > If I assert surgery without her consent, it is felony assault, not to > mention the civil liability. > > In addition, I must mention that I don't get paid for the vast > majority > of this care provided, I am liable if the patient decides to sue and I > must provide care emergency care (so if she is not really in labor and > is discharged, but shows up 2 weeks later in labor, she is mine) for > 30 > days even if I fire her from my care. > Lynn > > Lynn D. Montgomery, M.D. Next message: l.glazerman@rcn.com: "Re: Are there programs just for electronic" Previous message: Dr Eberhard W Lisse: "Re: vbac on demand" In reply to: Lynn Montgomery: "Re: vbac on demand" Next in thread: Efrain Ramirez: "Re: vbac on demand" Reply: Efrain Ramirez: "Re: vbac on demand"

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