Reply to Why did you pick a midwife over a doctor?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]"My argument is that inconveniences like long waits and office environment are not the markers of bad patient care, which, up until you responded was what we were discussing."

I'm not going to copy and paste the whole thing, but why do you think the above is true?  To people who don't have hours to wait for their healthcare providers, yes, long waits become bad care.  If the office environment is such that it ignores patient privacy, or doesn't facilitate communication between front office staff and providers, yes, it becomes bad care.

The quality of healthcare is, to me, comprehensive (and most organizations who research that construct agree).  Some aspects of care may be more salient than others, but it all goes into determining quality.  Also, if you look at the first page of this thread, most of the women described some version of wanting personalized attention/being listened.  One woman on the second page talked about wait times, clearly mentioning that she had experience working as a medical assistant in an OB practice, i.e., it was an informed decision.  Why are you focusing on wait times as the reason to argue that the women on this thread can't tell what defines quality care when what PPs are actually mentioning is providers paying attention to them?[/quote]

I'm a brand new poster to this thread. I have been reading this back and forth with growing annoyance.

I am a woman that had a very normal, uncomplicated first pregnancy become a VERY abnormal very complicated very dangerous pregnancy at week 33 very suddenly. My primary MFM at Georgetown was Dr Zilbermann. He was an enormous d. After stepping in the room to do my first BPP after being hospitalized he pretty casually informed me I was at a high risk of stillbirth. He also managed my care so that I made it to almost 37 weeks and delivered a baby that was breathing on her own. He predicted her stay in the NICU to the day. Dr. Drassinower was MUCH nicer to me and I liked her a lot and I have nothing but good things to say about her, but I trusted Dr. Z more by the end.

I waited for no less than 45 minutes for every appointment I had at Georgetown. They had crappy food and a crappy parking facility and crappy admins. And they saved my life and the life of my baby. And I was so grateful for that that when pregnant with my second I happily waited for those appointments again, and more frequently because I was high risk.

At the end of the day if sh*t really hits the fan, the rest doesn't matter. You really do want that weird antisocial guy that seems to know exactly what's going on with you.

To be fair I also think that overall patient care is important and the two should not be mutually exclusive. In my third pregnancy I got that. I was in a smaller city at a prestigious hospital and never waited more than 10 minutes and had excellent care.

And so if I was choosing I would rank them 1) great environment and great doctors, 2) crappy environment and great doctors, 3) great environment with blah doctors, 4) crappy environment with blah doctors, 5) great environment with people who aren't doctors.

I know I personally am biased here because my pregnancy was basically like, worst case scenario, but I agree with the PP that people really do put an oversized amount of importance on things that do not really matter in the end. And for the record, I don't think that means black women should accept not being listened to or that there aren't problems with OB GYN care in this country. But the midwifery model (outside of those groups associated with hospital practices) is just insane to me. Midwives in the united states are not trained and monitored in the formal way they are in other countries and until that happens I just do not understand anyone that doesn't have an OB as backup. My pregnancy was so dangerous that there was a real possibility that both myself AND my daughter would have died. I'm so happy my jerky doctor saved our lives, even if I do wish he had been a little more gentle.

[/quote]

I’m so happy the jerk doctor saved your lives, too!

Also, you admit your bias.  “Things that do not really matter in the end” was *your* experience.  That doesn’t mean these things don’t matter to other women.  What about women who skip appointments because they know they have to wait interminably?  Or the ones who don’t bother sharing information that seems trivial to them because they know they’ll be dismissed?  PP right that you summarily dismiss midwives as a whole, when CNMs have a great deal of medical training and expertise.  I’d never go to a CPM, but a CNM in a hospital?  Why not?

Other PP: yeah, it’s not productive to keep going back and forth.  Believe me, I know well how scheduling appointments and falling behind works (and the issues with insurance reimbursement)—and it’s great when the long waits are because providers are caring for their patients!  But sometimes they’re just overbooked.  And sometimes, those long waits mean that women just get up and leave, because if they stay any longer, they’ll get fired from the job that’s crappy about their medical leave (as happened repeatedly to my MIL—not during pregnancy, but for other medical reasons).  You’re right: warm and fuzzy doesn’t necessarily mean good medical care and unpleasant doesn’t mean bad medical care.  But, also, women on this thread generally weren’t talking about someone unpleasant, they were talking about someone who doesn’t listen to them.  And what I was really protesting was the confusion of those things. [/quote]

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