Comments on: Should family physicians continue to provide obstetric and maternity care?

By: Frank Drackman

Frank Drackman — Tue, 24 Mar 2009 07:41:00 +0000

So why not teach FPs to do Lap Cholys? Probably as many Gallstones out in the sticks as complicated deliveries… and at least only 1 patient gets screwed if you whack up Aunt Blabbies CBD…and you know why CNM’s have low CS rates, no OB/GYN with a lick of sense will have anything to do with them, and when you get down to it, Childbirths a natural event, that baby comes out fine 99% of the time no matter what you do..try leavin a necrotic gall bag in and see what happens…

By: Carla Kakutani MD

Carla Kakutani MD — Sat, 21 Mar 2009 18:28:00 +0000

I’ve delivered babies in my family practice for 17 yrs, in a community that also offers traditional OB and midwifery. But the difference is that I take call for my own OB patients 24/7 and deliver my own patients (unless I’ve made special coverage arrangements due to being out of town) The slow erosion of OB in family medicine is due to many things but probably the most crucial is the loss of a critical mass of family docs willing to teach OB, model how to integrate it into one’s life and provide coverage for each other. Doing OB certainly impacts your lifestyle, but the reward is huge. It keeps kids in your practice (if I wanted to only do adult medicine I would have become an internist) and creates a bond with your patients that is hard to describe. I’m lucky to work with a supportive group of OB’s at a supportive hospital with a long history of family docs doing OB. Despite that, we are down to just 3 of us still doing it.

By: Nicolas Bloch

Nicolas Bloch — Sat, 21 Mar 2009 03:17:00 +0000

This touches the general and serious problem of excessive malpractice law suites in medicine here in US . We end up with not enough or even without OB/GYNs, Mammographers e.g. in certain regions,… and at the end proper patient care is disabled by a misunderstood and abused liability concept, which should protect and not harm the patient. I am afraid we have not even hit the cusp of this absurd development.

By: realityrounds.com

realityrounds.com — Sat, 21 Mar 2009 00:38:00 +0000

You hit upon a very hot button issue in the OB department where I work. We are one of the very few urban hospitals that allow FP’s to deliver babies. The few attending FP’s that do provide maternity care, tend to serve an immigrant population and do a decent job with their patients. The FP residents on the other hand, that is a different story. Most of them have no desire to learn OB, and do not plan on delivering babies after their residency. The quality of care between the OB residents and the FP’s is very obvious (unfair comparison, I know). One bone of contention I would like to point out in your post is that there is no mention of certified nurse midwives. They essentially have the same OB practice privileges as FP’s. CNM’s have fantastic patient outcomes, extremely low C/S rates, nonexistent rates of episiotomies, and very high patient satisfaction scores. CNM’s would be more than capable for picking up the slack in rural communities where FP’s have abandoned maternity care.