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Fwd: Doula'sFrom: EWAITOB@aol.comThu Jul 25 20:50:06 1996
In a message dated 96-07-23 01:51:31 EDT, Ealgail@aol.com writes: << In some more conservative hospitals, they have to be dragged into the 21st century with much kicking and screaming. Just don't get run over while you are leading the parade. >> My doula in this case was not allowed back on the delivery floor. When I discussed this with the other patients she was helping with many become quite upset. Some, infact, changed hospitals entirely. I currently reside in Malvern Arkansas. The hospital administrator lured me here under the pretence of advancing obstetrical care at the hospital ( Before I came they were still laboring 4 patients in one room and taking them to a surgical delivery suite.) Many of the women in the town have been very receptive to change and this has been a big draw for new patients. You are right, however, that the nursing staff and FP,s (who are the only other physicians delivering here) have been very anxious about bringing modern obstetric practice into the hospital. The administator was concerned over medicolegal issues with the doula. Funny thing is, the FP's in town continue to do major gynecologic surgury ( i.e TAH/BSO) and nothing is said. This has been of great concern to me. I am currently in process of changing my practice location to Evensville Indiana. A number of issues motivate this move and I am looking forward to a change of venue. EwaitOB --------------------- Forwarded message: --------------------- From: Ealgail@aol.com --------------------- Sender: ob-gyn-l@listserv.bcm.tmc.edu Reply-to: ob-gyn-l@listserv.bcm.tmc.edu To: ob-gyn-l@listserv.bcm.tmc.edu (Multiple recipients of list) Date: 96-07-23 01:51:31 EDT I agree with Dr. Hill. When Administrators or other doctors are interested in activities...it is usually economic and can be very dangerous. People are irrational when you deal with their pocketbooks. Administrators can be won over if they are shown the public wants this and will change hospitals to get it. The key words are "profit center". Private obstetrics is a "profit center". Private gynecologic surgery follows the obstetrics and is, in most hospitals, the single most profitable area in the hospital, with 38 cents of each dollar in profit. Cardiac surgery may generate more gross dollars but usually returns 5 cents of each dollar. Ophthalmology and orthopedics can lose money, depending on the controls on the prosthesis used. Some Administrators don't know these numbers about their own hospitals...but we can and should educate them, so that Gynecology and Obstetrics gain their rightful place in the "new" economic power structure. In the meantime, be very careful. In some more conservative hospitals, they have to be dragged into the 21st century with much kicking and screaming. Just don't get run over while you are leading the parade. Doulas or their counterparts are well proven to help women alleviate anxiety in labor. Women with doulas require less anesthetic for labor and delivery in every study on the subject. If an obstetrician is in the room and in position to manage the delivery...hospital administrators and other physicians should "butt out". Remember, cab drivers, firemen, and ordinary husbands can and do deliver normal babies. We are just being paid to be there IN CASE they need us. Often they don't. Good luck. Linda Morrison-Boczar, M.D., M.B.A. Clinical Asst. Prof. Indiana Univ.
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