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#31 of 52 Old 12-05-2007, 06:35 AM
 
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#32 of 52 Old 12-05-2007, 04:56 PM
 
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Originally Posted by earthymama2b View Post
the more I BELIEVE that OB's get a cut/end of year bonus for how many babes they send to the NICU.....would anyone be suprised if OB's were gently 'nudged' financially to produce more early babies?
So you believe that OB's are being PAID 'by the baby' so to speak, for every baby they can have admitted to the NICU?

How do you suppose such a thing works? The hospital administration says 'Hey, Doc, if you send us 10 extra babies this month, we'll spot you a trip to Tahiti next spring.' Or is it more like 'Hey, Doc, we'll give you $5000 extra for every sick baby you can send us.'

That is one of the most absurd things I've read here, and that's saying a lot. :
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#33 of 52 Old 12-05-2007, 08:56 PM
 
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So you believe that OB's are being PAID 'by the baby' so to speak, for every baby they can have admitted to the NICU?

How do you suppose such a thing works? The hospital administration says 'Hey, Doc, if you send us 10 extra babies this month, we'll spot you a trip to Tahiti next spring.' Or is it more like 'Hey, Doc, we'll give you $5000 extra for every sick baby you can send us.'

That is one of the most absurd things I've read here, and that's saying a lot. :
No, not that blatant at all.

Many places (DH works at one now, and I used to work at one) have a bonus plan that is predicated on the overall 'success' of the business for the year. If they meet their goals, they get a certain amount, if they go over those goals by 10% they get a slightly higher amount, etc, etc. Bonus plans. The more each patient costs (have you SEEN hospital bills??!?!) the more the hospital makes, the more the hospital makes, the more the doctor makes.

Considering the cash cow that the Maternity Ward is for most hospitals, if a hospital had a bonus plan like the above, then yes, the OB's could directly influence how much of a bonus they got through inductions (simply because they cost MORE than a non-induced birth - the anetheisologist and the drugs alone) - and if the baby happened to come early, that's even more money via the NICU.



I think that most people are corruptible by money, esp. when they are taught/convinced that it's for someone elses own good.

And considering some of the exceptionally absurd things I've seen here, I'm suprised my little suspicion even tripped your radar.

I'm not saying I'm right, I'm saying I'm suspicious - whenever people start doing widespread illogical things, I follow the money. They certainly aren't doing it based on scientific backing, and considering how quick many doctors are to ignore their patients desires, it's not SOLELY because the mother wants it, and while I don't know how many malpractice suits there are out there for doctors daring to allow a patient to actually go into labor naturally, but I wouldn't think there are many ..... If you can come up with another logical reason for the widespread induction at 38 weeks meme that seems to be sweeping this country, I'd love to hear it.

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#34 of 52 Old 12-05-2007, 09:29 PM
 
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I'm sorry, OB's getting a cut of NICU costs? Okaaayyyyy :

And the iatrogenically premature babies are not the ones makin' the NICU's (and according to some, the OB's) any money. 36 weekers rarely need assistance simply for being uncomplicated 36 weekers. I know they sometimes do, but not very often.

If they really wanted money, they'd find reasons to induce at 28 weeks or less.

Still, I have never personally met an OB who would induce at 36 weeks for *&^%'s and giggles. I'm sure they exist, I just don't know any.
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#35 of 52 Old 12-05-2007, 09:44 PM
 
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Originally Posted by earthymama2b View Post
*weeps*

The more I read about the current state of maternal care and the insane push for induction, the more I BELIEVE that OB's get a cut/end of year bonus for how many babes they send to the NICU - I suppose if hospitals are making 50% of their money from the maternity ward (and I can only assume that the NICU provides a healthy chunk of that money) would anyone be suprised if OB's were gently 'nudged' financially to produce more early babies?

*cries* Poor babe.
It would certainly explain the USA being number 1 in infant mortality, wouldn't it? :

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#36 of 52 Old 12-05-2007, 10:09 PM
 
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I just never, ever, ever forget that hospitals are for-profit enterprises/businesses. Most businesses do anything they can to make MORE money than they did last year, and if an iatrogenically premature babe makes more money - without causing the babe or the family any long-term harm (even a day or two in the NICU costs more than a checkout 24 hours after birth).......

I'm suprised that people seem to think it's totally out of the range of possibility.

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#37 of 52 Old 12-05-2007, 10:23 PM
 
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Well, I was induced with my first on the 27th of December with a 1/10 due date. It wasn't due to convenience it was for my health. I had phlebitis and hadn't peed in a week. And you know what, it didn't work! Nada, nothing baby wasn't ready. We were given the option of going home, trying more pit or a c-section. I think we were unusual in that we actually packed up and went home. My phlebitis got a little better and you know - she was born on 1/10!
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#38 of 52 Old 12-05-2007, 10:28 PM
 
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Many many many hospitals are non-profit enterprises. My last hospital worked at a considerable loss (we took patients regardless of their ability to pay) which was made up for by donations.
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#39 of 52 Old 12-05-2007, 10:33 PM
 
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Many many many hospitals are non-profit enterprises. My last hospital worked at a considerable loss (we took patients regardless of their ability to pay) which was made up for by donations.
Just want to point out that being a non-profit organization does not mean that the hospital isn't trying to make money! Non-profit usually, at the end of the day, just means that the organization can show it has a legitimate purpose that will qualify it for non-profit status, and it wants more favorable tax treatment. And, of course, it has to meet some other pencil-pushing type of requirements. But making money is just as important to non-profit organizations, hospitals included, as for-profit corporations. The pressures may be somewhat different or come from different places (i.e., a non-profit hospital won't have publicly traded stock and shareholders to account to), but that does not mean that similar pressures don't exist, or that everyone is just asking from an altruistic or charitable frame of mind.

Whether the non-profit really is doing everything it can to achieve its charitable purposes has more to do with who's in charge (board of directors, etc.) and how scrupulous they are than than the legal tax status of the organization.
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#40 of 52 Old 12-05-2007, 11:55 PM
 
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Fine, but not for the purposes of giving the individual MD's, whatever their specialty, kick backs for "delivering" patients.

That's like saying the car companies get money from Trauma surgeons for making unsafe vehicles and therefore providing them with more business!

Beyond cynical IMO.

Maybe our NICU needs a new business plan because we only have 10 out of 20 beds filled at the moment. With legitimate preemies BTW. Unless you want to think the 26 weeker on the oscillator was induced for convenience.
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#41 of 52 Old 12-06-2007, 01:05 AM
 
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36 weekers rarely need assistance simply for being uncomplicated 36 weekers. I know they sometimes do, but not very often.
So, how often is "rare." 10% of the time, 30% of the time? Whatever the number is, it is more often than a 37-42 weeker, therefore more care is required than if the OB and mother had decided they wouldn't pick the green apples in hopes that they would ripen in the very expensive brown bag. And if a Level X NICU needs to maintain a certain occupancy to maintain the funds needed to stay a Level X NICU, I have to wonder if they would not put any pressure on the staff to find a reason for an NICU stay for at least some of these premies you say are just fine.
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#42 of 52 Old 12-06-2007, 01:19 AM
 
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Fine, but not for the purposes of giving the individual MD's, whatever their specialty, kick backs for "delivering" patients.

That's like saying the car companies get money from Trauma surgeons for making unsafe vehicles and therefore providing them with more business!

Beyond cynical IMO.

Maybe our NICU needs a new business plan because we only have 10 out of 20 beds filled at the moment. With legitimate preemies BTW. Unless you want to think the 26 weeker on the oscillator was induced for convenience.
No, it's more like car salesman trying to sell you on their warrenty plan in order to meet their quota. Or a saleperson in a department store directing you towards the more expensive pair of boots - to meet their sales goal.

If it's cynical to believe in the 'up-sell', I guess there are a LOT of cynical businesses/business people out there.

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#43 of 52 Old 12-06-2007, 01:23 AM - Thread Starter
 
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Just want to point out that being a non-profit organization does not mean that the hospital isn't trying to make money! Non-profit usually, at the end of the day, just means that the organization can show it has a legitimate purpose that will qualify it for non-profit status, and it wants more favorable tax treatment. And, of course, it has to meet some other pencil-pushing type of requirements. But making money is just as important to non-profit organizations, hospitals included, as for-profit corporations. The pressures may be somewhat different or come from different places (i.e., a non-profit hospital won't have publicly traded stock and shareholders to account to), but that does not mean that similar pressures don't exist, or that everyone is just asking from an altruistic or charitable frame of mind.

Whether the non-profit really is doing everything it can to achieve its charitable purposes has more to do with who's in charge (board of directors, etc.) and how scrupulous they are than than the legal tax status of the organization.
: Just because it's "not for profit" does not mean that the admin does not pad their wallets well.

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#44 of 52 Old 12-06-2007, 02:43 AM
 
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Guess what NICU's do when they aren't busy? They tell the nurses to stay home! Or they get transports from busier units. This happens a lot.
So wonder all you want that OB's are secretly plotting with Neo's to boost business. That's not what REALLY happens.
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#45 of 52 Old 12-06-2007, 04:17 AM
 
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Unless you want to think the 26 weeker on the oscillator was induced for convenience.
Well, I'm sure the baby's doctor has a boat payment he/she needs to make. : Gotta keep 'em coming, regardless of gestation length or outcome, it's all about these supposed kick backs that docs are getting for admitting more babies to the NICU.

Truly, this is one of the most absurd things I've read. Conspiracy theories usually make me chuckle, but this is just bizarre to think that someone truly BELIEVES that this is how medical billing and insurance payments actually work.

The OB that delivers the baby gets paid for prenatal care and delivery. Once baby is born, that's it. It's not like the OB is billing for care of babies in the NICU. That would be the neonatologists billing for those services. Are the neonatologists the ones paying the OB's extra 'bonus' money to send them more babies?

Where *exactly* is this extra money coming from, and from whom?
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#46 of 52 Old 12-06-2007, 04:22 AM
 
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No, it's more like car salesman trying to sell you on their warrenty plan in order to meet their quota. Or a saleperson in a department store directing you towards the more expensive pair of boots - to meet their sales goal.

If it's cynical to believe in the 'up-sell', I guess there are a LOT of cynical businesses/business people out there.

It's not the OB's that would be making money from having NICU babies though. Once they've delivered the baby, their job is done. They don't bill any more for a NICU baby than a healthy one.

Are you suggesting that the hospital is paying OB's to induce/deliver babies so early that NICU time is warranted? Are you suggesting that the neonatologists that would bill for NICU babies are the ones paying OB's extra for sending them more NICU babies? Who is it exactly that is in on this so called conspiracy to intentionally create NICU patients? Is there any proof of such a conspiracy, or is this all just baloney that someone pulled out of their rear end?
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#47 of 52 Old 12-06-2007, 04:28 AM
 
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Well, I'm sure the baby's doctor has a boat payment he/she needs to make. : Gotta keep 'em coming, regardless of gestation length or outcome, it's all about these supposed kick backs that docs are getting for admitting more babies to the NICU.

Truly, this is one of the most absurd things I've read. Conspiracy theories usually make me chuckle, but this is just bizarre to think that someone truly BELIEVES that this is how medical billing and insurance payments actually work.

The OB that delivers the baby gets paid for prenatal care and delivery. Once baby is born, that's it. It's not like the OB is billing for care of babies in the NICU. That would be the neonatologists billing for those services. Are the neonatologists the ones paying the OB's extra 'bonus' money to send them more babies?

Where *exactly* is this extra money coming from, and from whom?
It sure isn't coming from the largely uninsured populations we serve.
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#48 of 52 Old 12-06-2007, 10:41 AM
 
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apparently this is a new trend so that you won't have a "big baby" or get "stretched out".
The new trend is to put women and babies at risk so that mother's can be more sexually attractive to men? :Puke
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#49 of 52 Old 12-06-2007, 11:08 AM
 
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It would certainly explain the USA being number 1 in infant mortality, wouldn't it?
Not even close...

http://www.nationmaster.com/graph/he...mortality-rate

http://www.aneki.com/mortality.html

There has been a rise in US death rates - lots of sources attributing it to a disparity in prenatal and health care - especially among African American communities..

http://abcnews.go.com/Health/GlobalH...ory?id=1266515

I believe there is a need for women to empower themselves in general with information and their rights - and to advocate for their birth wishes. But I also think that the health of the baby needs to be taken into account and a mama's wish for a "perfect" birth gets trumped by that need, every time. I chose to have a hospital birth, and had a 26 hour labor and a doctor getting concerned and discussing c-section options with me. I listened to her concerns, and told her that if the baby or my vital signs became compromised, that we'd go in that direction, but that as long as we were both healthy and stable, that I wanted to continue in labor and deliver vaginally. The last thing I wanted was a c-section because of risk of complications to me, and the more lengthy recovery, but I wasn't about to chance anything for the baby's sake. It wasn't just about me.

The characterization of doctors who are deliberately putting babies at serious risk of complications and damage from premature inducing for the sake of profit is the height of paranoia and misinformation to me. I flat out don't believe OBs are monsters willing to hurt babies to get a bigger bonus.

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#50 of 52 Old 12-06-2007, 11:30 AM
 
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It's not the OB's that would be making money from having NICU babies though. Once they've delivered the baby, their job is done. They don't bill any more for a NICU baby than a healthy one.
And often in the case of a premature birth, especially if there is any kind of advance warning of labor or possible complications, the OB turns care over to a perinatologist. So in fact the OB might be totally out of the loop at this point. The mother would be cared for by a perinatologist, the infant by a neonatologist.

ITA that this is one of the more out there theories I have read here.
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#51 of 52 Old 12-10-2007, 05:01 PM
 
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i want to get back to this thread later.

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#52 of 52 Old 12-13-2007, 02:10 PM - Thread Starter
 
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Update-

She had her baby. She was induced monday. Baby is 6lbs, 18oz. Had a little trouble, but they are home and she is trying to bf this time.

Now family won't stop pressuring us to induce.

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