The Certified Letter-Fired by OB - Page 2

[PassionateWriter]

Originally Posted by Blu Razzberri

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

then start a new thread. the implication was that the OP deserved to be "fired" due to not "obeying". Sometimes i do believe doctors think they are on the same level as G-d..they certainly treat their advice as if it were religious doctrine.

[Blu Razzberri]

Originally Posted by PassionateWriter

then start a new thread....

Pardon?? The level of anger here towards one-another is TOTALLY uncalled for! I understand the issue itself is sensitive; but for the OP to get so upset because someone responded with what they knew (not even saying this was what always happens; or that the OP was doing anything to get fired); and then for you to pull the claws out on me for defending the reply; just totally unnecessary all around! Can we have some productive discussion instead of all getting mad at one-another??!!

[alicia9178]

Originally Posted by AmyLaz

What did the U/S show??

The ultrasound showed a baby who was measuring to date for everything but her abdominal girth which was 3 weeks ahead...luckily for me it is not the belly that can get stuck in a birth . It also showed an amniotic fluid index of 20, which was at the higher end of normal.....SCARY!!!!!!!!!!!!

Past that she was neurologically intact as far as can be seen by u/s, her heart was fine, and she has all of her pieces and parts.

So...to be honest....it showed a whole lot of NORMS!!

Alicia

[alicia9178]

Originally Posted by Blu Razzberri

Pardon?? The level of anger here towards one-another is TOTALLY uncalled for! I understand the issue itself is sensitive; but for the OP to get so upset because someone responded with what they knew (not even saying this was what always happens; or that the OP was doing anything to get fired); and then for you to pull the claws out on me for defending the reply; just totally unnecessary all around! Can we have some productive discussion instead of all getting mad at one-another??!!

I was not "upset" just clarifying. I know there are plenty of people in the world whether maried to a Dr or not who get sucked into the "Dr's are God" mentality and they could not imagine that a Physician would do something based upon their ego and not in the interest of a pt. To be honest...what a poster online says or thinks about me does not matter...I know the situation I am in and I appretiate the support of being able to come to this group of women to sort through feelings/situations.

So...I am not "upset".
ALicia

[Sigrid]

I'm sorry they're doing this to you. Sending a certified letter is kinda lame too. They should've called you in and spoken with you.

[robertandenith]

maybe he wanted to go on a vacation trip and wanted to schedule a c-section? not that it might be the case but I have a friend who's doctor told her she wanted to induce earlier because she was going on a vacation, how incompetent is that?!?!? My last OB didn't want to 'deal' with a water birth because he said it was 'yucky'. Yes some OB's lack of the proper 'care' they are supposed to give to their patients, they want the easier way out and don't want to deal with other than an easier birth or c-section. Have you seen "The business of being born" documentary? I am so looking forward to get my hands on a copy!!!!

[alicia9178]

OH...you HAVE to watch the Buisness of Being Born....it was great. Highly reccomend it to anyone pregnant or planning on becoming pregnant.
Alicia

[hyz]

Well, I certainly didn't mean to cause controversy, and PassionateWriter--I certainly didn't mean that Alicia "deserved to be fired" because she wouldn't "obey"! I was answering a question asked on this thread, and it didn't make any sense to me to start a new thread for that. I also said that it sucks for both the patient and the doctor in many cases--doctors feeling forced to stick to protocol they don't believe in, and patients being stuck with that protocol or getting fired because they won't follow it. I never blamed the OP for anything.

I know there are bad doctors, that there are doctors who schedule C-sections for their own convenience, and that there are doctors with huge obnoxious egos who can't take any disagreement. Trust me, I'm surrounded by a lot of doctors in my family, friends, and acquaintances, and I know that they are 100% human, and not like gods in the least. I know that medical schools attract some very unattractive humans, and that medicine turns some perfectly lovely people into very unattractive humans. For all I know, Alicia's doctor is one of these. I never said that he was right--I have absolutely no way of knowing that, and of course it does sound like he should've raised the issue in person before just sending a letter.

On the other hand, there are a lot of good doctors out there who are decent people who want to do the best for their patients, but are also terrified of being sued. I have heard that the AVERAGE doctor is sued 3 times in their careers (and OBs are sued more than average)--and this is drilled into doctors in hospitals every day--it is talked about CONSTANTLY among the staff, and they spend their whole days doing things so as not to get sued, and worrying that they might get sued anyway. The consequences can be very real. We had a family friend, a very reputable doctor who was sued towards the end of his career, and the insurance company wouldn't settle, because they thought it was clear he did nothing wrong and there was no real way he could lose. Well, he lost, the jury awarded damages far in excess of his insurance coverage, and he lost his life savings, everything he had worked for. He went home and committed suicide. Of course we all shook our heads and thought of all the other things he could've done instead--he could've appealed, he was in the right, etc., etc. But he was just crushed.

As for doing things AMA--it's sticky. Usually you see this when a patient leaves the doctor's care prematurely (in the doctor's mind)--so the doctor notes that it was AMA, meaning that there was other stuff he wanted to do to you, but you wouldn't let him, and you're not his problem anymore. That's fine. But if, for example, you refuse a c-section AMA, and the doctor continues to participate actively in your care and do the things that they think are risky, and something goes wrong, they CAN still be liable. The legal point of view is that if they didn't think it was right, they shouldn't have done it. But since they did it, they can be liable. And consent forms are gotten around pretty regularly in court--"oh, he just stuck that in my face and told me to sign it, didn't give me time to read it, I had no idea what it meant, etc." (and many times that's true)--so juries will find that there wasn't informed consent, and hold the doctor liable. So consent forms are no guarantee of anything. I'm a lawyer, so I have a good understanding of the law, and the realities of the situation--juries can be fickle, and cases can turn out in totally unexpected ways. Also, even if the doctor wins, lawsuits can drag on for YEARS, can be very expensive and exhausting, and no litigant ever gets that time back.

[alicia9178]

My only challenge to this is that I am a nurse and we are taught...no it is drilled onto our heads that documentation is your only safeguard in court. If it is undocumented then it never occured. I know liability is a big deal, but the reality is that we as women are being forced into things and bullied with scare tactics over liability...it is a sad state of affairs that because some people are sue-crazy that we ultimatly all pay for that. The all or nothing attitude that medicine has had to embrace is scary.
Alicia

[hyz]

Originally Posted by alicia9178

My only challenge to this is that I am a nurse and we are taught...no it is drilled onto our heads that documentation is your only safeguard in court. If it is undocumented then it never occured. I know liability is a big deal, but the reality is that we as women are being forced into things and bullied with scare tactics over liability...it is a sad state of affairs that because some people are sue-crazy that we ultimatly all pay for that. The all or nothing attitude that medicine has had to embrace is scary.
Alicia

Oh, I totally agree that documentation is your only safeguard--all I'm saying is that it's not even close to 100% effective, even when done well. Kinda like using the rhythm method to prevent conception.

I also agree with you that women are bullied into things, and that it's a sad state of affairs, and all of that. Honestly, I think US healthcare is a terrible mess right now, and it's not working out all that well for anyone, except for insurance companies raking in record profits, and some med mal plaintiffs' attorneys doing the same thing. The rest of us are stuck with the fallout. I've seriously considered doing a homebirth because I know that even a great doctor may feel compelled to order things for me that neither I nor she really thinks is necessary. DH and I aren't fully comfortable with this (yet, at least not this first time), but I'm glad you've decided to do what works for you--I certainly understand where you're coming from!

[PassionateWriter]

Originally Posted by Blu Razzberri

Pardon?? The level of anger here towards one-another is TOTALLY uncalled for! I understand the issue itself is sensitive; but for the OP to get so upset because someone responded with what they knew (not even saying this was what always happens; or that the OP was doing anything to get fired); and then for you to pull the claws out on me for defending the reply; just totally unnecessary all around! Can we have some productive discussion instead of all getting mad at one-another??!!

im not exactly where you are getting anger toward anyone here. i am certainly not angry..actually i am on a path right now of reducing stress and focusing on the positive.....what i said was not out of anger. I believe you were the one who stated that the OP should refrain from making a statement...

no claws here at all.

the productive discussion was hopefully going to center around the fact that dr's are not losing their shirts. sure, some dr's are sued and some lose but the rate of suits against dr's is overwhelmingly on teh dr's sides..not the patients suing. it is very difficult to WIN a case against a dr. If anyone is to blame, its the dr's for not standing up to their risk management teams at hospitals and their malpractice insurance co's..b/c those ppl should not be making medical decisions for women. period.

as an attorney, i would love to see a documented case against a dr. that was WON where the patient stated they did not want the procedure but then sued b/c the procedure was done. it just does not happen.

again..kill all the lawyers. its only the lawyers who are protecting patients, and most states cap liability, etc. etc. so the lawyers cant do that most of the time.

its a horrible horrible BIRTH climate. and OB's have attempted to take over this industry. MW's are much better at birth...however, i fear they too are being put into the same position....scared all the time of what "may" happen instead of looking at birth as what it is..the most natural thing that humans do. If we always needed all these interventions, we wouldnt have survived as a human race, yk?

to the OP, again, i say FILE A COMPLAINT AGAINST THIS DR. what he did was not just immoral, it was unethical. You should have been told why he was dropping you...to your face...not by receipt of a cert'd letter.

[Blu Razzberri]

Originally Posted by alicia9178

...I am not "upset"...

Excellent.

Originally Posted by alicia9178

...you HAVE to watch the Buisness of Being Born...

I'm hoping my sister picks up a copy when she's at the movie store tonight! I told her about it yesterday; and am currently holding my breath... (note: I'm not mad, I'm oxygen deprived )

Originally Posted by alicia9178

...some people are sue-crazy...we ultimatly all pay for that...

Very true; and very sad.

[hyz]

Originally Posted by PassionateWriter

the productive discussion was hopefully going to center around the fact that dr's are not losing their shirts. sure, some dr's are sued and some lose but the rate of suits against dr's is overwhelmingly on teh dr's sides..not the patients suing. it is very difficult to WIN a case against a dr. If anyone is to blame, its the dr's for not standing up to their risk management teams at hospitals and their malpractice insurance co's..b/c those ppl should not be making medical decisions for women. period.

You make it sound so easy. As an attorney, you probably know that "standard of care" is set on both a local and national level, and that individual doctors and even individual hospitals have very little effect on this in general. Certainly there is a problem, and things need to be changed, but unfortunately doctors continue to practice, and women continue to have babies in the very imperfect system we have NOW, and as a practical matter we all have to find individual ways to deal with that system.

as an attorney, i would love to see a documented case against a dr. that was WON where the patient stated they did not want the procedure but then sued b/c the procedure was done. it just does not happen.

Also as an attorney, you should know that you have just described the tort of battery (the unauthorized or unwanted touching of one person by another) and possibly assault (placing someone in fear or apprehension of such touching). Doctors can and have been sued successfully for that--in fact, just such a blackletter case appeared in my law school torts textbook--Mohr v. Williams, 104 N.W. 12 (Minn. 1905). Regardless, that's not the situation that's being discussed here. What is being discussed is if a doctor goes against "standard of care" and/or their own best judgment to provide the care that the patient requests, and something goes wrong. I don't happen to have any cases off the top of my head for that, and considering that I have actual paid work to be doing at the moment, I'm not going to run a search for you. Suffice it to say, I have heard many anecdotal reports of this happening, and there's no legal reason why those reports shouldn't be true. It doesn't have to happen all the time to be a problem--it only has to happen once--to you.

again..kill all the lawyers. its only the lawyers who are protecting patients, and most states cap liability, etc. etc. so the lawyers cant do that most of the time.

You're most definitely pitching this argument at the wrong person. As an attorney myself, I am often offended by the way lawyers are talked about in medical circles, by people who fail to recognize that there are good lawyers and bad lawyers just the same as there are for doctors, and who fail to see that lawyers (like doctors) are working within a system which they did not create, and which has many good points as well as bad points.

[holothuroidea]

This thread has illustrated exactly why I chose to have a home birth.

Because birth is birth and it simply should not be this complicated!!!

[hyz]

Originally Posted by holothuroidea

This thread has illustrated exactly why I chose to have a home birth.

Because birth is birth and it simply should not be this complicated!!!

I don't blame you a bit! I very well may do that myself next time around, but I'm going to give this hospital thing a shot this time....

[PassionateWriter]

Originally Posted by hyz

You make it sound so easy.

I certainly didnt intend to make it sound easy. Birth in the USA is one of the most complicated situations a well informed woman will find herself experiencing...its not easy, its not clear and its certainly not being presented by many dr's in a manner that is either clear or honest, in many situations.

I do not want to get into a legal debate...but when I see dr's defended here, its a bit of a slap in the face, as this is one resource that many women have to escape the "pro c/s, intervention heavy" culture of the current birth climate.

Originally Posted by hyz

As an attorney, you probably know that "standard of care" is set on both a local and national level, and that individual doctors and even individual hospitals have very little effect on this in general.

women keep trying to say NO to interventions...and NO to c/s's....and look what is happening to them? they get dropped....they are bascially abandoned....dr's refuse to take ppl who are "too high risk" (huh??? that just amazes me...dr's refuse to take women b/c they are inept to treat their medical conditions...just insane that they are allowed to risk out women from their care like that). dr's and hospitals are the ones who are profiting here..so IMHO they are the ones who need to change. Just as I would expect the pharmaceutical manufacturers to stop lying about vaccines....consumer groups et al can yell all they want but we need teh ppl who are profiting to stop lying to us.

Originally Posted by hyz

Also as an attorney, you should know that you have just described the tort of battery (the unauthorized or unwanted touching of one person by another) and possibly assault (placing someone in fear or apprehension of such touching). Doctors can and have been sued successfully for that--in fact, just such a blackletter case appeared in my law school torts textbook--Mohr v. Williams, 104 N.W. 12 (Minn. 1905).

Are you seriously citing a 1905 case here? Do you seriously believe that assaults and batteries do not exist in hospitals on a daily basis? Im a bit confused by this reference and the implication that you believe A&B is actionable against dr's and hospitals right now. I'm not going to go dig up the case (can if you ask...but really..i don't come to MDC to debate legal theory)....of a man who went to a hospital w/ an injury. they wanted to do a rectal examination and he did NOT want it. He screamed that he did NOT want it..they held him down and sedated him and gave him the rectal exam anyway (on the basis that they needed to rule out spinal injury - you would think the kicking and thrashing would have comforted them that his spine was ok). he sued. and LOST. That case, IMHO, pales in comparison to what happens to women on a day to day basis. And as far as I am concerned, informed consent is laughable in the birthing process. Dr's routinely tell women thigns that are just NOT true (e.g., 50% of VBAC babies die..thats a new one just revealed on the ICAN list).

Originally Posted by hyz

I don't happen to have any cases off the top of my head for that, and considering that I have actual paid work to be doing at the moment, I'm not going to run a search for you.

no need. i actually do not have a desire to read any law cases at this point, as I am currently in the process of focusing on my pregnancy and young children. I have been around the birthing community enough over the last several years to be firm in my convictions. But please....consider that perhaps you don't know all that you believe to be "true" simply from reading case law. Most of the trauma experienced by women in our current birthing climate is not going to end up in a law book.

Originally Posted by hyz

You're most definitely pitching this argument at the wrong person. As an attorney myself, I am often offended by the way lawyers are talked about in medical circles, by people who fail to recognize that there are good lawyers and bad lawyers just the same as there are for doctors, and who fail to see that lawyers (like doctors) are working within a system which they did not create, and which has many good points as well as bad points.

I am not pitching this argument to you...I simply responded w/ my beliefs in this thread re: the horrible treatment that many women receive at the hands of OBs. If I had my way in teh world, we would eliminate OB's from the business of birth and reserve them as the surgeons they are....which would assist many women and children in this country. They are not trained in natural child birth and should not be touting themselves as experienced as such.

sorry but I don't see the good points in the current environment, absent an emergency birth.

[PassionateWriter]

Originally Posted by holothuroidea

This thread has illustrated exactly why I chose to have a home birth.

Because birth is birth and it simply should not be this complicated!!!

exactly!!!! you should not have to sign all kinds of waivers for this and that, etc. etc. etc...fighting the battle from your first visit w/ the OB until you hopefully take your baby home....my birth with my MW was night and day compared to my births with the OB's. I would never have believed how different unless i had experienced it.

[bettie cracker]

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??

What she said, except I'm not in Canada.

That just really blows. Why didn't they let you know earlier???? Especially since this has been your healthiest pregnancy.

[JoyofBirth]

I think that you can have a great homebirth with your midwife. However, I do think I'd clear some things up with this doctor, possibly for your own peace of mind, possibly so that maybe he'll stop and think differently the next time he encounters this situation. You may call and schedule a time to sit and talk with him. I'd bring someone along and ask for his nurse to be present. I'd personally want to know why he was "firing" you, what his concerns are, why didn't he discuss them with you prior to the letter (I believe that he has to send the letter for his own records), I'd also ask him what is it that he thinks you should do for care (he is supposed to transfer care, not terminate). I'd tell him what your feelings are here in a calm but firm way and how you believe he could have handled it better. Then, I'd move on. Good luck. I hope it all works out just the way you want it and you can leave this behind you.

[alicia9178]

I actually for my peace of mind am getting my records from the office. They tried to tell me I would have to pay 0.20 per page, but I kindly reminded them since they discontinued care with me, not vice versa that I would not be paying and expect my records by the end of the week. So those will be insightful.
Alicia