...are the ones that make the biggest difference


Obstetrics 'R' Us

I'm sitting in a coffee house working on my joke of a communications paper - I mean, what exactly does a 5 page research paper accomplish? - and 2 men sitting at the table right next to me, who are either doctors or hospital administrators, are having a fascinating discussion about potential models for some hospital's obstetrics department. Given the sensitive nature of their discussion one would think they'd be a little more discreet, but such is not the case. The basic thrust of their conversation is how to market their hospital better while controlling costs through changing the way their hospital delivers babies. I was doing a good job of focusing on my paper until one of them started talking about why many doctors prefer c-sections to vaginal births. Apparently, traditional birth, ie, the way humanity has done it since we were created, is "hard" on a woman and c-sections are just better. Oh, and its relatively cheap, too. From there, they've moved on to talking about offering massages, facials and aromatherapy as well as a 30-minute sit-down with the doctor who will actually be delivering the child. Really? A whole 30-minutes with the man who will be cutting my wife open to save on malpractice insurance costs? Gosh, doctor, thanks for wasting your time with us.

Another way to contain costs, apparently, is also to take a "team" approach using several nurse midwifes under the direction of an obstetrician. At least one of the midwives will be at the hospital at all times in case of an emergency delivery and the doctor would be on call. This seems like a good plan - most nurse midwives are skilled & dedicated professionals, but they seriously questioned whether or not a woman should be given a choice in picking which midwife or doctor they wanted to bring their child into the world. They thought they could just introduce the whole team to the expectant mother and say "one of these people will do the delivery." One guy did have the sense to wonder if most women would go along with that system. From my perspective, I don't care what the women think I DON'T LIKE IT! No way would I want my wife and child left into the hands of the person who just happened to get the short straw that day. I want to know and trust the person who will literally be taking my wife's and my child's life in their hands.

Ahhh, the world of medicine-as-business...what am I getting myself into?


The Scrivener said...

It's insane, isn't it? I work in the health insurance industry, so I get a little bit of a glimpse into all this. The insurance side of the package is just as crazy.

As for picking the person who will deliver your baby... The biggest HMO here in California, Kaiser, doesn't really allow you to have any control over who delivers your baby. My wife saw three or four different doctors and nurse midwives during the course of her pregnancy. On the day of delivery, however, you get whoever is on shift. We ended up with a nurse midwife we had never even heard of before. Luckily, she was really great, but geez!

Anonymous said...

Get back to that paper! : ) This stuff will make you nuts.

The Scrivener said...

Been a while since you posted, Nathan. Hope all is well with you and yours and that you had a blessed Christmas!

Nathan said...

Doug -

We've just been busy with getting into our new place and finishing up this semester. We finally got our internet connection at home set up, so I should be back to regular posting from here on out. I hope you had a good Christmas and a safe New Years celebration.