Can you refuse service of a doctor?

[dmpmercury]

I love my OB and the midwife that I see at my practice and I had a wonderful birth with my ds at a hospital with the OB. He is very natural birth friendly and can even do breach births. He has lots of VBAC clients and never pressures people about due dates. The problem is his call schedule is changing so he will attend less births now. I can also use the midwife at the practice to cover more time.

I had a terrible birth experience with my dd. I went to a bigger practice and got an on call doctor I never met. The way he talked to me ruined my experience and he strong armed me into pitocen I did not want. I delivered vaginally but it wasn't a good experience and I ended up with a epidural I was hoping to avoid. He didn't deliver my dd thankfully. There is a slight chance that I could end up with him even at the smaller practice. I will be using a doula most likely and will try to arrive right before delivery like I did with my ds. I want my OB or midwife to deliver me but if it was one of the OBs I liked from the other practice or a unknown Dr I would be fine. I feel strongly I don't want this particular Dr to deliver me. On the off chance he would be on call could I refuse his care? Would they have to find someone else?

[Bellabaz]

I had a friend do this. She actually ahd a bit of a complication in that she went to the hospital because she didn't feel quite right. Something was wrong with her bp and they wanted to admit her and do all kinds of stuff. She refused and ended up taking an ambulance to a hopital further away where they had lovely midwives and everything turned out ok int eh end. She hadplanned a homebirth though so its a bit different situation. But I don't see why you can't refuse treament. Although it may mean you have to go somewhere else.

[Peace+Hope]

oops - double post

[Peace+Hope]

can you find out if your specific L&D has more than one OB on call at a time? maybe it would be worth talking to the head nurse at your L&D about. if there's only one OB on call at a time and it happens to be that ONE... they'd have no way of accommodating your request.

- hope you figure it out!!

[momongeon]

I'm confused. Is this Dr from your practice? Does he take call for your Dr? Here the only way you would end up getting the in house back up Dr is if your Dr was not present when the baby was crowning or needed a c/s. I am not sure how the call goes at that practice or hospital. We are a bigger hospital and most practices have at least 4 providers and as I said before they deliver all their own pts unless your doc didn't make it in time. It that point you will probably not even see the guy until the time of delivery. I may be way off but if he is part of the practice you could ask the midwife to "special" you and then she would be on call just for you until delivery. I did that with my MW and it happened to work out for us. I would have been fine with all of them though.

[lifeguard]

The practices around here that have this sort of arrangement don't really allow for much flexibility. Basically if you sign up with them you sign up for care with whomever is on duty when you go into labour, whether you like that particular doctor or not. I would think your only chance of choosing whether to go with the ob you don't like is if there are 2 on duty at all times.

[possum]

My mom is an OB in private practice. She sometimes has special patients with special situations that she will come in for even if she is not on call. She makes arrangements ahead of time with them and makes a note on their chart so the hospital staff will call her. These are generally people who have circumstances for which she feels very stongly and with whom she has a special bond - not just people who decide they don't want her partner for some reason. She chose the other doctor because she thinks he is a reasonable, well-qualified physician, and she doesn't seem to feel kindly towards people who don't have a really good reason (in her opinion) for not wanting to see him. I think you will likely find that most doctors who are in practice with each other will probably back each others' medical decisions. My mother has had some special patients who needed care from a female because of religious reasons and some with whom she was close - like staff from her office. I think she has lots more requests for special treatment than she accommodates. There's a reason she chose not to be in solo practice and always on call.

At the hospitals where my mother has worked, in addition to each practice having an on call doctor, there is an OBGYN on house call in case someone comes in who does not have a provider of her own. Generally, each doctor is required to take this kind of call as part of having hospital privileges. At my mom's hospital, they take this extra call a week at a time, and any time my mother is on regular call, she takes her partner's house call and v/v.

So if you showed up and the doctor you don't like is on call for your doctor and he was also the person on house call for the hospital for anyone without a doctor, then you would be up a creek if you refused his services. The hospital would be under no obligation to find another doctor for you, and they would very likely give you the choice of staying for the services they can provide or not. I would not envy anyone who got into that situation. It seems like it would get really touchy.

I think if you really cannot bear the idea of this person attending you at all, then a home birth with a midwife or a hospital birth at a different hospital with a different practice are the only reasonable choices.

Melinda

[mamabadger]

We had a situation at a local hospital where all the OBs were very nice, flexible about birth procedures, etc. except one doctor, who was not only rigid and interventionist but also had the worst bedside manner you could possibly imagine - he had women in tears because of the way he spoke to them. Word got around, and women in labour took to phoning the hospital before they left home, and asking which OB was on duty. If it was Doctor Evil, they would go to a different hospital and take whoever was on call. I am not sure this would work in every case, since hospitals might refuse to give out that information.

[AAK]

Originally Posted by mamabadger

We had a situation at a local hospital where all the OBs were very nice, flexible about birth procedures, etc. except one doctor, who was not only rigid and interventionist but also had the worst bedside manner you could possibly imagine - he had women in tears because of the way he spoke to them. Word got around, and women in labour took to phoning the hospital before they left home, and asking which OB was on duty. If it was Doctor Evil, they would go to a different hospital and take whoever was on call. I am not sure this would work in every case, since hospitals might refuse to give out that information.

The hospital might not tell you, but you could ask at each prenatal visit who would be on call for the week. I did this, it reassured me to know who I would get.

[Turquesa]

Originally Posted by dmpmercury

On the off chance he would be on call could I refuse his care? Would they have to find someone else?

Yes and yes. I know for sure that you have a legal right. I would also check the hospital's Patient's Bill of Rights because those often remind you of that right. Some may phrase it as your having a right to "choose the provider." Good luck.

[possum]

The right to refuse care is not the same as the right to have a hospital search until they find someone you deem acceptable. You don't have to accept the care of anyone, but they do not have to have an unlimited number of people available for you to choose from at any given moment.
Before my mother started her own practice, there was only one OBGYN group in town, and more than once she was the only OB in town for the day or weekend. There were no other choices.
Melinda

[MegBoz]

Originally Posted by possum

The right to refuse care is not the same as the right to have a hospital search until they find someone you deem acceptable

Yes, I wouldn't think the "patient bill of rights" allows you, legally, to refuse the care of the doc on call, and, therefore force the hospital to call in another doc. I highly doubt you truly have a right to that.

I would think the same would apply in the Emergency Room. They only have so many ER docs in at a time. If you need care, you don't get to ask them to call in someone else because you don't like who is free when you arrive.

This is probably different from non-emergent care, such as scheduling a diagnostic procedure. You have the right to schedule it with the doc of your choice, but when you arrive at the hospital and need care now, it is just a different story, unfortunately.

I also asked at my prenatals who was on call over the next few days so I knew. (Although my MWs switched off every few days, they weren't on call for a full week at a time.) There was one MW I really didn't like & when I was stressing about it, my doula was a great comfort. She made some comment like, "We'll make it work even if we have her." OK, it was much more articulate than that, but what she conveyed was, "Your DH & I are your "birth team" & we're going to support you to do this thing, if we have a minor irritation such as your least fav MW, we'll get through it. You'll be supported & we won't let it disrupt us from the path we're on for your goal."

That made me feel good. So, if you find that avoiding this doc isn't an option, then maybe re-framing it in your mind & getting the support of others around you is the key. AND... you can always refuse his 'care'! i.e. refuse vaginal exams, refuse to get into a position where he could poke around your privates (squatting on the floor?), make sure DH can catch (again, so he's not poking around your privates, yanking the baby out, etc.) Even if that is not typically "allowed" you do NOT have to go along with their standard 'rules'!