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Re: fetal monitoring--response to Dr. NageyFrom: EvelynMcH@aol.comSat Dec 23 09:04:22 1995
In a message dated 95-12-23 01:38:04 EST, you write:
>I feel sympathy for the ordeal that you went through.. However, every story has two sides. It is a shame that your caretaker is not present to voice his/her interpretation of the events that lead up to your premature delivery, instrumental delivery, and perineal laceration. I did not make my comments to start a debate that is out of place in this list. I made them to state that the interventions practiced as part of the birthing process are often much more a matter of risk management than sound medical practice. My doctor - who certainly behaved like a "caretaker" rather than a partner or advisor in this situation - would defend every one of his acts as necessitated by the result of the previous intervention. Judging by your comments here, in that physician's place, so would you. That does not mean that the circumstances were justified because they can be justified.
>We in the practice of Ob-Gyn are forced to deal with the simple fact that That is the nature of what you do. It's part of the job. It's also part of your job to give the best possible care and weigh the consequences of what you do. The attitude in your comment makes me wonder how much understanding you give to those patients that faced with complications and issues like genetic testing and the uncertainties of the entire act of childbirth have to make decisions, have a right to make those decisions and expect your counsel, not your rulings on what they must do. As a patient, asking questions and questioning procedures is an absolute right. But that right is usually treated as non-existant in the face of medical necessity in the opinion of the physician, even if the "necessity" is simply a matter of opinion. I am very sorry that I let one person's opinion of what was necessity, an opinion that the majority of those I have spoken with since disagree with, lead to a series of events that might very well have left me with that impaired infant and have left me impaired. That is bad medicine, the kind that I would hope that no one would be defending, including those that practiced it. Simple questions like the side effects of medications, long term effects of techniques like high level ultrasound, cerclage, steroids, epidurals and other common practices are not attacks on the physician. They are attempts to ensure that what interventions are made, are made for a reason that is more valid than just a medical CYA. The medical community should welcome them as a part of the evolving practice of doing the best to get the best possible outcome.
>I don't know you personally and would hesitate to guess on your inclination The attitude in this comment says it all. And it is absolutely the nature of the problem. I feel sorry for patients that expect medicine to solve every problem, including the unsolvable. I have no sympathy for those that look at those patients as the enemy in what should be a mutual effort. That is the worst possible form of medical practice. And in this day and age, litigation or not, there is no excuse for it and no way to justify it. If you dislike the people you deal with so much, you - not you personally, but in the generic sense - are in the wrong trade. Lest I be bombarded with comments that I do not understand what it is to be a doctor, let me state that my two oldest and closest friends are a pediatric oncologist who is head of her department at a very large institution, and a family practitioner who's father was my family doctor for almost thirty years. I understand the pressures that the medical profession is under from health insurance and legal issues. I understand that doctors are humans and not gods. I am just surprised that there are so many willing to use litigation as an excuse to do less than what is ultimately best for the patient, even if it is harder, requires more research and more questioning of "the way it is done". Those things are the only things that improve medical practice. (now going back to lurking)
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