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Dismissal from OBGYN
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Anonymous
| I know someone that was dismissed from her practice because she told her dr that she refused to have a c-section even if the baby's life was in danger. They had a couple of discussions about this, and the practice ended up telling her that she had to leave. She ended up getting mid-wife. |
Anonymous
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I think if the two philosophies of giving birth are not the same, this is best for both parties. The OP has every right to ask questions and strive for a particular birth experience. But, from the dr. perspective, I can see the VERY specific birth plan situations being really annoying (I'm not saying that is the case here). That's not going to be a popular opinion on this board but oh well.
If the two parties are going to conflict, why is that a good situation for either? Simply saying "the dr has no flexibility" in that situation is idiotic. Sorry, it is. You'd still want to see a doctor who didn't want to see you? Ummm, good luck with that. OP-she/he did you a favor. |
Anonymous
My friend has a hysterical story about this re: her first baby. She talked to a few friends and became militant about a natural birth. She carefully created her birth plan. She presented it to her OB who got annoyed and told her off. He really was sort of rude about it. She was mad, but pragmatic enough to stay in the practice. Anyhow, when she went into labor, she was in so much pain that she was begging for an epidural nearly right away. The nurses had to tell her to hold off. (I could have predicted this, but wisely kept my mouth shut.) She laughs about it now. And she's still with the same OB, and she's had TWO more babies with him. The third was a c-section. Ten pounds, six ounces and breech to boot. But three healthy children. |
Anonymous
I think PP here is correct, that the OB did OP a favor. Nonetheless, there is a difference between wanting to have a reluctant doctor (who would?) and whether or not that doctor has a right to dismiss a patient. Whether or not you think it is idiotic, the fact remains that doctors must follow certain steps in dismissing patients. From OP's description, this doctor did not follow the appropriate steps and it doesn't appear that she had what the AMA would consider a valid reason for dismissal, either (asking too many questions or a personality clash are not sufficient reasons for dismissal, which should rather be reserved for cases like abuse or continual non-payment). Different states have different regulations on how much notice must be given, but the AMA simply states that the notice must provide sufficient time for the patient to find alternative treatment (and recommendations should be given). Finally, the AMA requires doctors to send this dismissal in writing, preferably by certified letter. So it may be idiotic, but it is the AMA who has made that call, not other posters who are simply educating you on the AMA's ethical requirements with respect to the doctor / patient relationship. As others have noted, doctors take an oath to serve the public and not to serve the slice of the public that doesn't ask them taxing questions. The AMA has set strict guidelines on when and how doctors may dismiss patients. OP, if you're still reading, it would be useful to know how the doctor phrased your dismissal. Did she tell you outright that you were fired or did she hem and haw and intimate as much until you were the one to say it? As OP pointed out, it seems totally fair (and okay by the AMA) for a doctor to talk with a patient about concerns over clashing -- another thing altogether to just fire you in such a backhanded way. Interesting link by the NY Times: http://query.nytimes.com/gst/fullpage.html?res=9F03E6DC1530F936A15757C0A9669C8B63 |
Anonymous
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OP here:
First of all, thank you everyone for your replies. I should make clear that there was a conversation over the phone and the Dr did the dismissing. She said a letter would go in my file, but I haven't received anything. I keep thinking back to our telephone conversation and I still don't really get it. She did tell me I was planning for things I had no control over and not to bother with a birth plan. When I had indicated that there was a procedure I did not want done on delivery day she said that she could "convince me" on delivery. I told her I wasn't comfortable being "convinced" and wanted to know if I had a choice on delivery day. She did say I would have a choice. Maybe this is where she felt we were butting heads and the bartering issue came up? I will say that I was very polite. If she believed that there were "trust issues" then I wonder why there wasn't an initial discussion. While I can appreciate that it might be helpful to some if I named the practice, I don't feel comfortable doing so at this time. First, this happened shortly after I posted something here and named the practice, so I think there may be something there. Second, other people have spoken well of the practice. Third, no one else seems to have ever been dismissed from a practice, so this doesn't seem common enough that naming the practice will result in a measurable benefit to anyone. Fourth, if we do file a complaint - I can only imagine that me naming the practice here can lead to more unpleasant action from them. The main lesson to me is to try to find an OBGYN who supports a natural birth. It is true that I want to aim for a natural birth, but I also made clear to the doctor that a healthy baby is priority. I hope I can now find an OBGYN who will support that goal. Are natural childbirths and OBGYNs really that incompatible? Uhhhh... I think I have to let this go - I need to go back there in a few weeks and I don't want to stress out little one any more. That said, we may consider talking some action. Does anyone know how to file a complaint with the AMA? I looked on their website but didn't see anything about that? Hoping that everyone has a peaceful and pleasant pregnancy. |
Anonymous
I'm not going to say "no" because some women (usually by luck or easy labors) do wind up with lovely natural births with OBs, but the reality is that OBs are simply not trained in natural, normal birth. They are trained surgeons. In every other field, we hire highly specialized and interventive specialists only if and when our case needs that level of care. In the case of birth, OBs do not necessarily know what they can do to facilitate a NORMAL delivery. OP, find a midwife! They are the ones that hold the knowledge and skill to help you have a baby with minimal interventions. Most of the midwives in this area have c/section rates that are less than 10%, in comparison to OBs who have c/section rates (for first time moms; their overall c/section rates are much higher!) of 20-30%. Why choose a care provider who winds up intervening when it is not necessary, especially since you want a low-intervention birth? There a number of well known midwifery practices who work at hospitals in the area, in case you are interested in a hospital delivery. My favorite is Whitney Pinger, who has a solo midwifery practice based at Washington Hospital Center. You owe it to yourself to interview her before you rule out the idea of the midwife. You simply have no idea how fantastic your prenatal care can be, until you've met with Whitney Pinger. You will be in shock about how amazing she is. I truly believe she is the best kept secret in maternity care in all of Washington DC. The other midwifery practices in the area are also very good, and if you go with the DC Birth Center, then you will have the option (as long as you stay low risk) of delivering at their birth center, where they encourage you to make use of their jacuzzi tub and will do a water birth if you want. |
Anonymous
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OP you would file the complaint with the state medical board where she is licensed. Below are links, VA and MD are on line.
Her informing you that she put a letter in your file is ridiculous. You need to point out that she did not provide you any time to find alternative care, did not inform you properly. I would also point out that she did not offer a valid reason, you were not non compliant, did not fail to pay and she objected to your questions. The dismissal is clearly out of bounds. I would strongly doubt this is he first time she has done this. Seriously, there are probably more women out there who feel as badly as you do. Reporting her can make a difference in only making her think twice about how she talks with patients. Good Luck Maryland http://www.mbp.state.md.us/pages/cform.html Virginia http://www.dhp.state.va.us/enforcement/complaints.htm For DC you would mail a written complaint to: DC Department of Health Health Professional Licensing Administration Professional Assistance Program 717 14th Street, NW, 6th Floor Washington, DC, 20005 |
Anonymous
OP, good luck to you, I know you will find someone you are comfortable with. I am wondering why you say that you have to go back there in a few weeks? |
Anonymous
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OP here:
I need to go back because the doctor ordered my 20 week ultrasound which is next week. I am assuming the radiologist doesn't give me the results, but sends them to the doctor??? Would the radiologist tell me the result when i have the ultrasound or do i need to go back for them? |
Anonymous
| OP, you do not need to go back to get an ultrasound. There is no urgency to getting that sonogram, none at all. Some practices don't do ANY ultrasounds during pregnancy unless you want one. There is no reason to ever go back to that doctor or practice. Take a couple weeks to find your new provider, and when you go in for your appointment they will either give you an ultrasound right then (presuming you want one) or schedule an ultrasound somewhere. |
Anonymous
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It has been my experience that the tech measures the baby and all their parts and then talks to a doc (radiologist? - not the OB). Once the doc came and told us everything looked good and another time the tech returned after talking with the doc and said everything looked normal. They send a report to the OB. You can probably say you are in the process of switching OBs and ask for a copy for the new one, if you haven't chosen one yet. Or, it can be sent with the rest of your records.
I have been told that the measurements need to be taken in or around the 20th week for proper reading. Not sure if that is just one doc's opinion. |
Anonymous
| I just don't see what is to be gained by "reporting" the doctor other than to be punitive . . . just my opinion. Move on, OP. |
Anonymous
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"I just don't see what is to be gained by "reporting" the doctor other than to be punitive . . . just my opinion. Move on, OP. "
Are you a doctor who does this? If someone robs you is it better to move on than file charges? Afterall it was probably just a quirk that they decided to rob you..would never happen again if no one was punitive to the offender. Reporting the doctor only involves filing a complaint. Its completely the OP's call. I was really outraged not only by the doctor's actions but at how bad the OP was feeling and now wondering what to do about the 20 week sonogram. This was so unfair to the OP and it really burns me that a medical profession would behave this way toward a patient. Patients, even brilliant, informed and tough ones, are vulnerable and the medical profession is trained to know this. |
Anonymous
Do they have classes in taking advantage of vulnerable patients at all the medical schools, or only some of them? |
Anonymous
| I believe GU teaches its students that they are better than everyone else. |