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Re: Abnormal hemoglobinFrom: LMCNM@aol.comThu Jan 23 01:44:51 1997
A twin pregnancy can be managed effectively by a midwife-physician team. A patient with a twin pregnancy might rotate visits, be discussed at MD-CNM meetings and a care plan drawn up, or see CNM with an assigned number of MD visits-- ie once every month, week or whatever. The management plan will be based on the best solution for the practice-- ie MD has surgery or an emergency and he delegates the CNM to see patients in the office. We hate cancelling hours as it cuts into our income when 20 patients go unseen. You can never quite make up the loss and you often lose patients when they are not " taken care of ". That is only part of the benefits of a collaborative practice. I can see no real difficulty with this type of collaborative practice when the two professionals are working together for the good of the patients and the practice as a whole. If we can separate our egos and professional rivalry we could really co-exit and benefit ourselves and our patients. I probably have delivered 25 sets of twins with my back-up physician. He comes to the hospital for the delivery or when I call him and we have had a wonderful relationship for many years. He is a gentle man and I respect his judgement-- even if I don't always agree with him. Sometimes he even listens to me and agrees with my alternative ideas! It definately has worked when two people respect each others opinion. Lonnie C. Morris CNM, ND I have a great deal of respect for the MD's that I work with and I will do anything that will help the clients and assures that they are well cared for. Lonnie Morris CNM, ND
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