The Certified Letter-Fired by OB

[alicia9178]

So...I got home today and found a notice for a certified letter at my door. I literally got in my truck and tracked down the mail lady...the stalker side of me...lol. It was fro mmy OB...they have decided...without my input that I am to high risk to deliver at the same hospital I have had 4 of my 5 babies at and so they are discontinuing my care. I am sick. Being back in OH the ONLY thing that I felt ok with was being able to deliver at the same place I had been at so many times if necesary. I know what I can get away with there, and I know I can sign baby out AMA with out an issue.

So now I am stuck. It will be hard pressed to find a Dr who will look at my chart and history and really want to take me on as a client. I am planning a HBAC, but the reality is I have to also prepare that I could need a hospital...and where does that leave me???? I am feeling as though I live in the twilight zone with everything that has happened the past few months.

ALicia

[holothuroidea]

....

I don't know what to say... It just makes me so mad!!!! You're going to have your HBAC, you should tape it and strap them to chairs and force them to watch it. Like, really shove it in their face.

Too high risk? Did your uterus explode or something? That seems so outrageous to me, "we can't take care of you because the risk is too high." Risk of what? Risk of malpractice, that's what.

RAAAWRRR *rampage*


*heavy sigh*

[MySunflowerBoys]

Oh no! What rotten news! I'm so sorry, hope you can find a better, more confident OB to back you up.

[robertandenith]

what? that's just bizarre!!!! I can't believe it, is there a reason to believe you are at high risk?

[veganf]

If you just show up at the ER in active labor they can't turn you away. Not ideal, but if you do feel the need to birth at the hospital...

[fyoosh]

Keep planning on having your HBAC. Think positive!!! If you have to transfer, there is always the ER. But think positive in that you won't have to transfer I hate OBs for normal birth honestly, and will only see one if something absolutely *MAJOR* is going wrong (no longer normal birth).

[alicia9178]

Originally Posted by robertandenith

what? that's just bizarre!!!! I can't believe it, is there a reason to believe you are at high risk?

I have insulin resistance related to PCOS...my blood sugars have been perfect with oral medication, but they keep LABELING me GD. On top of that I am VBACing . Then there is the fact that this is my 6th birth..., you know you can hemorrhage if you have to many babies. Oh...and a history of pregnancy induced hypertension in 2 of my 5 previous pregnancies.

Ironically I have been healthier with this pregnancy then my previous 3 that this SAME office cared for 2 of those 3. It basically boils down to the fact that I am difficult...I ask questions, I challenge their protocols, I refuse to just bend over and take whatever they say without good reason....it all boils down to the fact that I am a "BAD" patient .

So now I am faced with either going to rest of the pregnancy with no prenatal care...or searching for some other S-OB to "care" for me.

Ironically I feel better not having to deal with them...last night I was cleaning the kitchen and just felt a release in a way.
Alicia

[westernskies]

That is terrible I am sorry! I know you are planning a HBAC (GO YOU!!!) but if you were not, what in the world were you supposed to do? That is absurd that an OB can fire YOU. I have heard of people firing their OB, but the other way around is nuts. Are you seeing a midwife at all or are you planning a UC?

[alicia9178]

I do have a midwife who will attending out HBAC hopefully. She is phenominal and very supportive. I am at the point now where we are saying that we will step in the hospital if there is a medical need...signs of PIH, complications during labor, etc. The good thing is that at that point I get to make the choice where I can go...and so I can then go to the hospital that I would have been at and have had all my babies at.
Alicia

[meredyth0315]

Oh Alicia, I'm so sorry! But you know this got me thinking...

OB's always make themselves out to be heroes, but by them saying you're too high risk just shows how inept they are. They should be doing everything they can for you, sending you to a peri and so forth, but to just drop you from their care, well that says what kind of "care" providers they are and you certainly don't need them!!! I would even be tempted to seek legal advice since their concerns are so many about your pg, but yet they don't want to deal with you. Just absolutely insane :

I'm glad to hear you have a mw that will be attending. You can always go to the hospital you're comfortable with *if* the need to transfer arises. I'm doing an HBA2C and don't see any need for interventions - keep thinking positive thoughts and you'll have your VBAC!!!!!

[PassionateWriter]

Originally Posted by alicia9178

So...I got home today and found a notice for a certified letter at my door. I literally got in my truck and tracked down the mail lady...the stalker side of me...lol. It was fro mmy OB...they have decided...without my input that I am to high risk to deliver at the same hospital I have had 4 of my 5 babies at and so they are discontinuing my care. I am sick. Being back in OH the ONLY thing that I felt ok with was being able to deliver at the same place I had been at so many times if necesary. I know what I can get away with there, and I know I can sign baby out AMA with out an issue.

So now I am stuck. It will be hard pressed to find a Dr who will look at my chart and history and really want to take me on as a client. I am planning a HBAC, but the reality is I have to also prepare that I could need a hospital...and where does that leave me???? I am feeling as though I live in the twilight zone with everything that has happened the past few months.

ALicia

seriously, i konw this is going to be a hard pill to swallow but look at this as a blessing. you arent 38 weeks and having to search for a care provider....and now you know their attitude. nothing is preventing you from transferring to that hospital if you have to in an emergency.

i just had to fire my MW at 18 weeks. i literally feel sick w/ dread but yk, she wont be at my birth, hindering my progress, yk? that will be a good thing regardless.

on another note, i would seriously file a complaint w/ teh medical board. this should have been discussed with you. if they want to send a certified letter, fine. but that should not be your first notification that they didnt want to take you. thats just mean and wrong.

good luck in your search. i bet you find someone great (and this is coming from someone who lives in a state that prevents any MW from attending me....check out my other thread "looking for a hbac MW in NH"..not an easy thing to do).

you WILL find someone. and you WILL have a great birth. just keep repeating that to yourself and try to stay positive. stress hormones are NOT good, yk. s

[Blu Razzberri]

(I'm in Canada)
I'm shocked to learn that your doctor can just 'get rid of you'; especially this far into your pregnancy!! Aren't there laws to protect you or something??

[robertandenith]

I am sending you good vibes to you, that's just stupid. I totally agree with what meredyth0315 says, that's one of the reasons I have a midwife this time around. Then how come many years ago women used to birth more than 10 kids with no problem? There is always the emergency room, BUT I know you can do it on your own...

[hyz]

Originally Posted by Blu Razzberri

(I'm in Canada)
I'm shocked to learn that your doctor can just 'get rid of you'; especially this far into your pregnancy!! Aren't there laws to protect you or something??

My DH is a medical resident, and as far as he's seen, patients are "fired" when they will not follow the doctor's advice in ways that the doctor believes will lead to high risk and possibly bad outcomes. The reality for doctors is that they know they can be sued for tons of money if something goes wrong, even if it went wrong because the patient wouldn't follow the doctor's recommendations. They can lose their homes, their life savings, and their licenses. Patients can and do claim that "the risks were never fully explained to them" and "they didn't understand" and "it's the doctor's job to give me the care I need--they went to medical school, not me"--even when the doctor repeatedly tried to make the risks of the patients preferences very clear, and documented those conversations.

It basically sucks on both sides, for patients and doctors. There is a legally established "standard of care", which isn't always good for patients, and which many doctors disagree with for lots of reasons. "Standard of care" can involve many unnecessary tests, procedures, etc.--all of which CAN be harmful to patients. However, if doctors don't follow this standard, they are extremely vulnerable to suit if something goes wrong. Doctors are more often sued for NOT doing something than for doing something (i.e. no monitoring vs. monitoring, no c-section vs. unnecessary c-section...). My DH's advice to me in this birthing process was to stay home as long as possible--as long as you are at home, they can't tell you what to do (i.e. no eating, IV hookups, constant fetal monitoring, limiting labor time, etc.), and you can't sue them. After that, try to be sure that you have a doctor whose philosphy is as similar to yours as possible--someone with a record of low surgical intervention, etc.--basically, someone who is willing to accept the personal risk associated with not following "standard of care" to the letter.

I don't know the situation in the OP's case--I'm sure some doctors are quicker to fire patients than others, and that can be really obnoxious--but I've never heard of a doctor firing a patient just because of their pure medical risk. If the doctor simply believes s/he is not equipped to handle that level of medical complication, they will generally refer to a more specialized physician. I suspect this is based more on the OP "challenging their protocols"--even if she was entirely reasonable (from our perspective) in doing so. I hope she will be able to find a doctor who's a better fit--this could be a real blessing in disguise.

[~Megan~]

Well your chances of needing to transfer are quite low so it probably won't ever come up.

If you are using a midwife she probably has a hospital or set of doctors that she feels comfortable transferring to if needed.

I'm sorry they are mistreating you so much but in the end it will all be okay!

[Blu Razzberri]

Thank you 'hyz' for taking the time to clarify! That sounds like a seriously sucky situation for both the patient and the doctor at times! I feel bad for the OP given the timing!

[alicia9178]

Originally Posted by hyz

My DH is a medical resident, and as far as he's seen, patients are "fired" when they will not follow the doctor's advice in ways that the doctor believes will lead to high risk and possibly bad outcomes. The reality for doctors is that they know they can be sued for tons of money if something goes wrong, even if it went wrong because the patient wouldn't follow the doctor's recommendations. They can lose their homes, their life savings, and their licenses. Patients can and do claim that "the risks were never fully explained to them" and "they didn't understand" and "it's the doctor's job to give me the care I need--they went to medical school, not me"--even when the doctor repeatedly tried to make the risks of the patients preferences very clear, and documented those conversations.

I don't know the situation in the OP's case--I'm sure some doctors are quicker to fire patients than others, and that can be really obnoxious--but I've never heard of a doctor firing a patient just because of their pure medical risk. If the doctor simply believes s/he is not equipped to handle that level of medical complication, they will generally refer to a more specialized physician. I suspect this is based more on the OP "challenging their protocols"--even if she was entirely reasonable (from our perspective) in doing so. I hope she will be able to find a doctor who's a better fit--this could be a real blessing in disguise.

First off...I did not go against anything the Dr recommended. I monitored blood sugars, had ultrasounds, saw the perinatologist, etc. I followed their requests. What I would not "agree" to was a scheduled C-section, which ultimatly was for the MDs convenience. I NEVER said I would refuse this or refuse that..I expressed my concerns with some procedures, but NEVER refused anything except an unnecessary C-section. I am a VERY educated person. I have worked L&D as a RN, and in the ER. The reality is that Dr's do not like to be challenged. The notion that a Dr will not fire someone for no reason is true in a way....they have reasons....reasons like they do not want to be challenged. The legal reality is that if you DOCUMENT accuratly and have the patient sign documentation that they have been EXPLAINED the risks and benefits and are taking responsibility for their actions...it is on the pt....INFORMED CONSENT !!!! I cannot dismiss what happened as right by the MD because of liability. If they had a problem with my u/s that I had (which was their excuse on why i was high risk), then call me into the office and discuss options with me. A certified letter shows an utter disrespect.
Alicia

[PassionateWriter]

there are waiver forms for the dr's to have patients sign. Drs. are not liable for women who chose to provide AMA. Dr's fire patients all the time b/c alot of them feel they are gods and if women aren't listening to them, then those women just need to go away. it happens ALL THE TIME.

this whole liability scare is so overrated....patients who have been wronged by dr's LOSE 80% of the time. dr's arent losing their homes, cars, etc etc. b/c of a woman wanting some control over their medical care. the ones who do lose for one, most of them have malpractice insurance but two, the ones that lose are the ones that really really screw things up.

its always the lawyers that are blamed. *sigh*

[AmyLaz]

Originally Posted by alicia9178

If they had a problem with my u/s that I had (which was their excuse on why i was high risk), then call me into the office and discuss options with me. A certified letter shows an utter disrespect.
Alicia

What did the U/S show??

[Blu Razzberri]

Originally Posted by alicia9178

First off...I did not go against anything the Dr recommended....

Whoa whoa....she didn't say YOU specifically. She was talking about generally!

ETA: I really do feel bad for you. Isn't there anything you can do about this? I mean, you wouldn't want the same doctor, obviously; but some restitution or something?