This letter is causing a firestorm over at MedPolitics.
An anesthesiologist unloads on the obstetrics profession, where he feels that they take patient rights too far.
The source is a .PDF file, so the letter is re-printed in it’s entirety:
If the tone of this epistle is less cordial than you’re used to, well then so be it. I’m feeling a bit surly.
It is 0230 again. We could have done this case nine hours ago. The sun was still up, and she’d been stuck at 6 cm longer than the life cycle of some butterflies. We should have done this case nine hours ago, but the patient “really wanted” to delivery vaginally. Apparently becoming a mother just wasn’t enough, and the actual avenue of the child’s arrival had some bearing that I, as a sleep-deprived and callous male, just couldn’t grasp.
She had been told that the baby was too big and that a primary C-section was indicated, not what she wanted to hear. She doctor-shopped until she found one who agreed with her diagnosis.
It doesn’t always happen this way, but this time we got a meconium-stained, cone-headed, floppy baby that required resuscitation. I guess that balances with the patient’s need to labor and attempt an ill-advised vaginal delivery. Or not.
No other specialty has allowed itself to deteriorate to the state of patient control that obstetrics has. We are all concerned about patient rights. We have to be. But come on. Let’s say you have a kidney stone and you present at the urologist’s office wincing with pain but holding in your hand a seven-page stone-retrieval plan and a list of dates that are satisfactory to your social calendar (and as a bonus would make the stone a Libra) ““ the urologist would and should inform you that his afternoon was booked but that his esteemed colleague from across town would (he’s sure) be happy to see you.
Patients don’t always know best. I’m not suggesting that doctors always know best. I am suggesting, however, that we can make an expensively educated guess and be right enough of the time to eclipse the records of Jean Dixon, Nostradamus or the average meteorologist.
Good medicine should not infringe on the patient’s rights. I’m afraid our brethren in OB have let patient’s rights infringe upon their medicine.
