Dismissal from OBGYN

[Anonymous]

I'm the DA poster. I'm also an attorney and some would say I'm a bit neurotic (and at the very least a worry wart). I fancy myself as having a Google MD as I researched everything during my pregnancies and asked tough questions. Having said that, I'd like to point out that there is a right way to ask questions and a wrong way to ask questions. It all comes down to tone and actually demonstrating an interest in what your doctor has to say as opposed to making declaratory statements and being totally dismissive or combative when your doctor provides guidance. I seriously doubt a doctor would dismiss a patient for asking lots of questions. My doctors lovingly call me high maintenance -- but I haven't been dismissed. I have great relationships with the docs who care for my family b/c while I always have several questions for them, I actually listen to what they have to say and digest their counsel prior to making decisions -- and I never fly off the handle or make them think that I don't respect their opinion. The bottom line is that I did my homework beforehand and found excellent doctors who I trust (that's not to say that I don't ask tough questions -- I just approach things in a diplomatic way -- it's called being polite, and it is quite effective).

[Anonymous]

Please let us know the practice. Or at least if it is MD, VA or DC?

[Anonymous]

Goodness, DA, what in OP's original (and very polite) message made you think she'd been impolite? She mentioned specifically that she didn't like some of the questions that she asked about c-sections and also thought there was a chance that the doctor had identified her from a post here. I'm not saying there's no reason to point out that there is a right and wrong way to ask questions, but I also don't think a patient needs to pussyfoot around her concerns. Doctors can put on the big boy pants and deal with nervous, fearful, educated, and maybe even hardheaded patients. It's their job to do that.

[Anonymous]

Anonymous wrote:You know, as nasty as it was of this doc to do it this way, she probably did you a huge favor. It sounds like she was not the least bit interested in dealing with an expectant woman who had educated herself or trusted herself enough or had enough self confidence to ask questions that she had.

Educate yourself and ask questions? How DARE you?

Please don't take this experience as anythign other than a positive reflection of you. Seriously. Do not let this lady make you feel bad about yourself.

This is a really long winded way of saying, "fuck her," I guess.

I agree with this post, and frankly, I think a lot of birth experiences would be better if more doctors had the balls to admit they do not want to deal with even a pseudo-natural birth. This DR did you a favor, OP.

[Anonymous]

Sorry about how it all happend to you- voice mail is not acceptable.
Having said that- Dr.'s have the right to turn down patients...just as you have the right to walk away.
Good luck finding a doctor that is the right fit.

[Anonymous]

I also agree that voice mail is not an acceptable way to deliver this news to you. I'm surprised it was not a face-to-face conversation.

[Anonymous]

First off, to the OP-- I'm sorry that this had to happen to you during your pregnancy. It's just awful, but it's probably for the best.

As a general matter, I'd say that it's appropriate for a doctor to drop a patient that she/he didn't feel they could have a good relationship with. I'm sure some Drs. fear that they will be pressured by certain patients into doing something they don't think is in the best interest of the mother/child. My guess is that this is a fairly common fear among Drs. lately given the popularity of "birth plans" and overload of "take charge of your birth" messages coming from every direction. While I think it's good to be proactive and informed over your health care decisions (I sure was/am) some women don't let the Drs. do their job. If I were their Dr., I would be worried about those patients.

Maybe this Dr. was overly sensitive to some of the questions that the OP asked... maybe she thinks C-sections are the way to go... who knows. What she should have done is recommended another practice.

[Anonymous]

Anonymous wrote:I also agree that voice mail is not an acceptable way to deliver this news to you. I'm surprised it was not a face-to-face conversation.

Can't you just see them charging a co-pay for the office visit for a face-to-face?!

[Anonymous]

I understand your frustration on the matter, but I think it is for the best. I had a pushy doctor for my first and I ignored the personality clashes we had...and I lived to regret it. During labor, she complained constantly that it was taking too long (only 8 hrs) and repeatedly threatened me with surgery when I asked any questions and when I became scared. It was horrible and has affected my trust in the medical community.

There are some that believe pregnancy & birth is a medical process that needs to be managed and others that believe that it is a natural process that requires intervention only when a need arises. Finding a caregiver that jives with your beliefs is key. I just wish it were an easier process to find the right fit.

[Anonymous]

To the OP -

Did you find a new doc yet? Please feel free to ask for recs because I know there are many folks out there that have had good experiences and would be happy to refer you to a more suitable doc.

[Anonymous]

"Having said that- Dr.'s have the right to turn down patients...just as you have the right to walk away. "

This simply is not true. The patient has the flexibility to simply walk away. A doctor can not do the same. If a patient leaves (moves, stops coming, or takes some other affirmative action to end the relationship) and then returns to the doctor, the doctor has more flexibility to refuse to take back the patient. A doctor can not simply dismiss or fire you without following the process required by the state medical board.

This is a very important ethical rule. I have zip sympathy for a designer ob/gyn not wanting to deal with patient questions about natural childbirth. There was nothing in the OP's language that would indicate she was rude in anyway, in fact she didn't express fury she expressed how upset and depressed she felt. This doctor made her patient feel like crap for asking questions.

There are so many doctors who deal with truly non compliant patients, patients with mental defects, and patients with serious dysfunctional personality dynamics but they follow their oath and continue care. There are many doctors who are dealing with elderly patients who due to their illness can become very combative or patients in chronic pain desperate for any path and these doctors respect their oath and continue care. These populations that are most difficult to deal with often have a higher likliehood of not gaining alternate care and their health would be compromised if they stopped. When you go into medicine this is what you sign up for to help people..not a small slice of people you like, but the public.

Personally, I am very tired of some of the ob/gyns moving toward a spa rather than an ethical, evidence based medical practice. I'm getting off topic here but this trend toward taking no insurance, charging high fees to buy a BMW, decorated waited rooms, cosmetic procedures at your ob.gyn (one I know now raves about doing laser hair removal as a great money maker and marketing tool to attract patients who can pay more), elective c-sections, and unethical patient selection process is just bad medicine. You don't get to select your patients as if you were running a private school or country club.

[Anonymous]

Anyone remember the delivery scene in Slackers?

[Anonymous]

Anonymous wrote:"Personally, I am very tired of some of the ob/gyns moving toward a spa rather than an ethical, evidence based medical practice. I'm getting off topic here but this trend toward taking no insurance, charging high fees to buy a BMW, decorated waited rooms, cosmetic procedures at your ob.gyn (one I know now raves about doing laser hair removal as a great money maker and marketing tool to attract patients who can pay more), elective c-sections, and unethical patient selection process is just bad medicine. You don't get to select your patients as if you were running a private school or country club.

Yet there seems to be a demand for such services and treatment... so the docs aren't the only ones to blame...

[Anonymous]

Anonymous wrote:

Anonymous wrote:I also agree that voice mail is not an acceptable way to deliver this news to you. I'm surprised it was not a face-to-face conversation.

Can't you just see them charging a co-pay for the office visit for a face-to-face?!

Bwahaha! Good point.

[Anonymous]

"You don't get to select your patients as if you were running a private school or country club."

And, you don't get to dictate how a trained medical professional will handle your pregnancy, labor and delivery by adhering to a strictly defined birth plan. I'm not saying that the OP was such a patient, but her experience should serve as a gentle reminder to ladies to do their homework beforehand and find an OB with a similar philosophy in terms of labor and delivery. Some of the posts on this forum highlight the fact that many women want an earthy-crunchy non-medical type birth -- which is totally fine -- and yet they also want an OB on hand (sometimes along with their doula) but they just seem to want the doc and the hospital just in case and not because they value the doc's opinion or medical services. Seems odd.