Re: OB Videotapes
From: James S Smeltzer MD (gaperina@mindspring.com)
Thu Sep 16 16:39:26 1999
Paula,
I know that we need to be cost-effective, but not at the expense of
inadequate examinations. I know that giving the patient an archive of the
exam is a strong disincentive to do an inadequate one. Jim S
At 09:05 PM 9/12/1999 -0500, you wrote:
>Hi, Paige.
>
>I believe the SDMS has a policy statement on keepsake videotapes.
>
>Unlike performing sonograms for entertainment, not diagnosis (something
>I believe almost all of us oppose), should we be making keepsake videos
>in the course of an exam? This was a hot topic in our department.
>
>The sonographers (myself included) were unanimously opposed to them.
>Some physicians thought it was a nice gesture, and others worried about
>issues of time, medicolegal ramificatons, and patient dissatisfaction if
>they could not see "the baby."
>
>I should note that whenever possible, we do give one or two keepsake
>images. In theory, a videotape is just a variation of that. Our
>opposition was based on practical concerns, not philosophical ones.
>Ultimately, those practical concerns guided our action. At a business
>meeting, we voted against making keepsake videotapes. Now, when a
>patient asks for one, the sonographer says, "I'm sorry, but there's a
>department policy against it."
>
>Before your administrators come to a decision, they should be prepared
>to answer:
>
>Who would provide the tape? How would it be paid for? How much time (per
>fetus and per pregnancy) should be devoted to making the tape? Who
>should make it--doctor or sonographer? Should a doctor review each tape
>before it's released? What happens if a videotape is used in a lawsuit?
>Do you need to keep a copy of each tape the way you keep the other
>images? Do you only offer to tape singleton pregnancies? Sonographically
>normal ones? Only at a certain gestational age?
>
>The administrators should remember that insurers are trying to cut
>reimbursement rates, which means we have to try to improve efficiency.
>Are they willing to support the extra time videotapng takes if it
>reduces volume by a patient a month? A week? A day?
>
>Finally, would they be considering providing keepsake videos of the
>patients' gallstones or sonohysterograms instead of their fetuses?
>Obstetrical ultrasound is no less of a detailed, specialized, diagnostic
>medical procedure. Where will they draw the line?
>
>Good luck. I'd like to hear the outcome.
>
>Regards,
>Paula
>
>At Sun, 12 Sep 1999, PFC wrote:
>>
>>I know this subject has come up many times but I was not successful in
trying to find info in the archives.
>>
>>I need information that will support a decision and formal written policy
against video taping for the patient. Has anyone been involved in a lawsuit
or know of any? Are there any guidelines set out by SDMS or ARDMS? We
need some solid information to pass on to the administrators so that they
can make and informed decision.
>>
>>Thanks for your help! BTW, can anyone tell me how to use the archives?
>>
>>Paige Cobb BS, RDMS, RVT
>
>--
>Paula S. Woletz, RDMS, RDCS, MPH
>University of Medicine and Dentistry of New Jersey/
>St. Peter's University Hospital
>New Brunswick, NJ
>woletzps@umdnj.edu
>
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