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#61 of 79 Old 04-19-2008, 10:28 PM
 
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There are quite a few physicians, nurses and other health professionals that post here. Do you really think we'd be wasting our time on MDC if we didn't share common beliefs with the people here?
and in my experience..they would be the exception to the rule.

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#62 of 79 Old 04-19-2008, 10:34 PM
 
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and in my experience..they would be the exception to the rule.
That's my point-- why does there have to be a 'rule'? Why is it okay to make negative generalizations at all?
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#63 of 79 Old 04-19-2008, 10:35 PM
 
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That's my point-- why does there have to be a 'rule'? Why is it okay to make negative generalizations at all?

Because it's human nature.

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#64 of 79 Old 04-19-2008, 10:43 PM
 
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Because it's human nature.


And that, ladies and gentlemen, is a cop-out.
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#65 of 79 Old 04-19-2008, 10:46 PM
 
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And that, ladies and gentlemen, is a cop-out.

Nope...just the truth. People make judgments on their experience all the time. If we didn't, nobody would ever get out of bed in the morning.

Done arguing with you Couz...you continue believing what you need to believe to get you through the day and so will I.

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#66 of 79 Old 04-19-2008, 10:56 PM
 
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I'm just saying that if you replace the word 'physician' with, say, the word 'Italian' or the word 'Jewish', no one would simply accept generalizations that paint an entire group with one brush based simply on the fact that some people have had bad experiences with some members of that group.
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That's my point-- why does there have to be a 'rule'? Why is it okay to make negative generalizations at all?
IMO, there's a big difference between a group of people such as Italians or Jews, and a group such as physicians. Physicians choose to work in the medical model (I'm not slamming that, in and of itself, as I realize there are many, many reasons for that choice). Physicians receive training in their field, and many of our objections to the industry are, to at least some extent, directly related to that training. We're talking about representatives of a specific industry, who choose to work in that industry - not about people who happen to have been born Italian, or Jewish, or Chinese, or Russian, or...whatever.

Are there still exceptions - OBs who really do have respect for a woman's personal autonomy, and some grasp of the potential repercussions to that woman and her family from the decisions they make about us? Of course there are. The problem is that we have no way of knowing what we're dealing with until it's too late...and the deck is stacked against us.

Lisa, lucky mama of Kelly (3/93) ribboncesarean.gif, Emma (5/03) ribboncesarean.gif, Evan (7/05) ribboncesarean.gif, & Jenna (6/09) ribboncesarean.gif
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#67 of 79 Old 04-19-2008, 11:55 PM
 
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This is reminding me of a thread long ago....
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#68 of 79 Old 04-20-2008, 02:45 AM
 
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The generalizations don't bug me so much because I feel that they don't apply to me. I am a practicing allopathic physician, and I attend hospital births, some of them quite medicalized, but that's not my whole story, or my whole identity and I know it. Occasionally I get sensitive and I like to see those disclaimers ("we know there are some good physicians out there" type of thing) but I also know that many people's entire lifetime experience with my profession is not too encouraging. My self esteem and my sense of self worth is not that tied up in what other people think of my profession or other people in my profession they've met. I hope that anyone who knows me personally will give me the benefit of the doubt before making a judgement about me, but I also know that people use their past experiences to help them judge new situations, so that means I sometimes have to work hard to overcome the negative things other folks in my profession have done. That's okay, that's life, no biggie.

I think allopathic medicine long ago made the choice to try to set our practioners apart from our clients. Instead of being the community midwife, or medicine man, or whatever, we wanted to be seen as a class apart, by the very nature of our training different and above our clients. My training re-inforced that in me, and it has taken me some effort to move away from that type of hierarchal practice. Doctors prescribe and patients comply (or are non-compliant!) and doctors dispense scientific knowledge that is above what patients know about their own bodies. I have worked in my own life to move away from that kind of thinking to be a community provider, someone who builds relationships and seeks to help my clients maximize their own health. I tell my clients how I reach my conclusions, what factors I'm using in decision making, and encourage them to take responsibility for their own decisions.

I also think, surprisingly maybe, that I worry far less about malpractice than many docs. My clients are all people I know - from my community where I live, where my kids go to school, where I work and shop and go to church - and I have real relationships with the majority of them. They make their own decisions, using my input as a factor hopefully, but ultimately, their own. I think shifting that responsibility means that my clients know what I know - I'm not trying to pull off some kind of atmosphere of infallibilty, or hide any uncertainty from them. If I don't know (and believe me, it happens a lot that I don't know for sure whats going on) I tell my clients so. I really think a lot of the malpractice fear in the US especially has to do with the fact that allopathic medicine is an instution where physicians what to remain powerful - we want to be authority figures. I think if we were all willing to admit that we don't know everything, that sometimes there is a lot of uncertainty in our practice, that decisions need to be made by the people they affect taking into account the factors that are most important to THEM, not us, there would be a lot less reason for people to sue.

Not sure how I got off on my malpractice diatribe. Anyway, I'm not personally bothered by the generalizations, but it is nice to see an acknowledgement now and then that people are individuals, and what one doctor does (or even a whole bunch of doctors) doesn't mean that's how every single doctor acts.
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#69 of 79 Old 04-20-2008, 02:52 AM
 
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This is reminding me of a thread long ago....
Only one?

Seriously though, near as I can tell the doctors and nurses who practice evidence-based medicine do so despite what you were taught not because of what you were taught. You're the ones to put forth the (apparently*) extra effort to treat patients as individuals, to research the findings in you fields, to basically not just blindly follow the standard protocols.

As I was explaining to my husband tonight, I trust all doctors and nurses to practice perfectly well to the extent of their training--I don't trust that training to be in the best interests of physiologically normal birth. I believe there are plenty of doctors and nurses who are capable of acting in the best interests of physiologically normal birth, but I believe that you are rare enough that I have to assume otherwise until pleasantly surprised.

*"apparently extra effort" because if it's not extra effort, why aren't all doctors and nurses doing it?
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#70 of 79 Old 04-20-2008, 04:14 AM
 
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I also think, surprisingly maybe, that I worry far less about malpractice than many docs. My clients are all people I know - from my community where I live, where my kids go to school, where I work and shop and go to church - and I have real relationships with the majority of them. They make their own decisions, using my input as a factor hopefully, but ultimately, their own. I think shifting that responsibility means that my clients know what I know - I'm not trying to pull off some kind of atmosphere of infallibilty, or hide any uncertainty from them. If I don't know (and believe me, it happens a lot that I don't know for sure whats going on) I tell my clients so. I really think a lot of the malpractice fear in the US especially has to do with the fact that allopathic medicine is an instution where physicians what to remain powerful - we want to be authority figures. I think if we were all willing to admit that we don't know everything, that sometimes there is a lot of uncertainty in our practice, that decisions need to be made by the people they affect taking into account the factors that are most important to THEM, not us, there would be a lot less reason for people to sue.
I think this is very true. If something had gone wrong with my second or third baby, I'd have been tempted to sue (probably wouldn't have done it, for a variety of reasons - but I'd have been tempted), because of the OB's attitude towards me throughout at the end of the second pregnancy, and all through the third one. I don't like being treated as if I have no brain, and as if my own opinions about my own body and mind are invalid, because they don't agree with the "expert". (After being told for NINE MONTHS that I would be depressed if I had a c-section, both my family doctor and the OB expressed tremendous surprise when I was depressed after ds2 arrived. Yeah - nice to know you were listening and gave a crap.)

OTOH, I had a heartbreakingly bad outcome with Aaron and I have no desire whatsoever to sue anyone. My care provider never tried to promise me a healthy baby. She never tried to pretend that she had the power to make things come out right. I don't blame her for not being able to do something that she never claimed she could do in the first place. Most doctors I've dealt with do imply a promise that if I just sit down, shut up and do as I'm told, then everything will be just fine. They can't deliver, but that doesn't change anything.

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#71 of 79 Old 04-20-2008, 07:46 AM
 
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I have recently been referred to an Ob (I grudgingly requested it), the MW knows my fears and concerns and we looked at which Obs were available and she told me 'this one is quite woman centred'. WTF? Being an Ob, I would expect them ALL to be woman centred.

I haven't had good experiences with Obs, I don't diss them all because I don't know them all, but the ones I have so far come across, have been less than respectful (understatement). I know there are good Obs out there, but from my experieence, they are very hard to come by.

As it goes, I am not too trusting of anyone in the medical profession, I haven't had good experiences and would in fact, rather be treated by the local vet.
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#72 of 79 Old 04-20-2008, 12:58 PM
 
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WTF? Being an Ob, I would expect them ALL to be woman centred.
No crap!

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in fact, rather be treated by the local vet.
Me too, at least I've never heard a vet blame the dog for what ever is happening to it.
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#73 of 79 Old 04-20-2008, 02:05 PM
 
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Fyrestorm: Wow, that is all I have to say about your experience. It must have been far beyond horrific. I wish I could apologize for them, but I can't. I too do not believe what makes me function is how "good" or "bad" patients think I am. I am what I am and I think I am a great RN who cares deeply for my patients and works hard. I DO NOT generalize my patients and group them together like some patients do to me. "Oh great, here comes the dumb RN who doesn't know sh*t from a hole in the wall" I get that look a lot...haha. I am not here to argue with you. I just want you to know THERE ARE nurses and OBs (*gasp* I said the "O" word!) who care. I wish you could meet my OBs, I think you would like him and his wife. I hope one day to become and OB myself and maybe, just maybe, I will have patients who look to me as a positive person and not a bad woman. I wish your experiences could have been better and hope you find peace within yourself. I am done posting in this thread, it is not being productive for me personally....wish you all the best.
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#74 of 79 Old 04-20-2008, 02:20 PM
 
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I'm not touching your birth story, Fyrestorm. We've all heard it. I'm just saying that if you replace the word 'physician' with, say, the word 'Italian' or the word 'Jewish', no one would simply accept generalizations that paint an entire group with one brush based simply on the fact that some people have had bad experiences with some members of that group.

There are quite a few physicians, nurses and other health professionals that post here. Do you really think we'd be wasting our time on MDC if we didn't share common beliefs with the people here?
Last I checked, profession was not a protected class.

Out of every person I know who has had a baby, I have not heard of *one* who had an evidence-based and caring birth experience with an OB. Not one. Every single one was lied to in the most egregious ways - your baby is too big to deliver vaginally, it is not safe to be "late," etc. I think this is the same experience as most of us on MDC - every woman is lied to and manipulated and deprived of the most basic considerations, and the doctors act as though they are doing them a favor. I've had an OB directly admit that the only reason he is still in practice is because he figured out to schedule elective sections and inductions and now works banker's hours and earns twice as much. :Puke Sadly enough, it seems that most people actually enjoy and are comforted by this sort of "care" from their doctors, so if that is what you need to hear, march on over to BabyCenter.

DS1 2004 ~ DS2 2005 ~ DD1 2008 ~ DS3 2010 ~ DD2 due Dec. 2014
On hospital bedrest for pPROM since 23 weeks
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#75 of 79 Old 04-20-2008, 02:29 PM
 
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Out of every person I know who has had a baby, I have not heard of *one* who had an evidence-based and caring birth experience with an OB. Not one.
I know I said I was not going post here anymore, but I just HAVE to say I DID have an awesome birth experience with my babies by a truthful, honest caring OB. He was great!!!!!! (Oh but you said people you knew, and you don't really know me so I don't know if that counts.) Marching to Baby Center...nah, those people aren't much fun.
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#76 of 79 Old 04-20-2008, 02:38 PM
 
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This weeks "green" issue of TIME magazine has a short and VERY biased article about elective c-sections. Not once did they mention the increased risk of hemmorage, infection, or death with these surgeries. It is a terrible, one sided article - I just might write a letter to the editor . . .

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#77 of 79 Old 04-22-2008, 12:09 AM
 
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Another L&D RN here. I tend to agree with those that say there are very, very few OB's (and RN's) who know HOW to practice evidence based care. It's a big problem. As one of the nurse educators said to me when we were discussing the Cochrane database (which publishes standards of evidence based care based on studies), "yeah, well the OB's don't like them much. They have this hang up with that 'wooden spoon award' that Cochrane keeps giving them for the specialty with the least amount of evidence based practice..."
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#78 of 79 Old 04-22-2008, 07:58 PM
 
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I don't get on the defensive when I read or hear medical industry and doctor bashing because I know I strive to approach my patients as humanistically as possible and have had to sort of swim against the tide myself. I am an osteopathic physician and chose this side of medicine because of the philosophical ideals for patient care and interaction that are promoted during training. I felt that rather than be an outlier in my approach to patients in the usual allopathic model of training, I would find more support in the osteopathic model. Though I ultimately ended up subspecializing, all my training, (med school, internship, and residency) was done through osteopathic institutions which continued to promote and support my principles. The end result is that I practice ophthalmology with an osteopathic philosophy.

The tenets of osteopathic medicine that really spoke to me were (from AOA web):
First, do no harm. A thoughtful diagnosis should be made before exposing the patient to any potentially harmful procedure.

Look beyond the disease for the cause. Treatment should center on the cause, with effect addressed only when it benefits the patient in some tangible way.

The practice of medicine should be based on sound medical principles. Only therapies proven clinically beneficial in improving patient outcome should be recommended.

The body has the potential to make all substances necessary to insure its health. No medical approach can exceed the efficacy of the body’s natural defense systems if those defenses are functioning properly. Therefore, teaching the patient to care for his own health and to prevent disease is part of a physician’s responsibility.

Osteopathy embraces all known areas of practice.


I was able to experience excellent and thoughtful care from my osteopathic OB/GYNs in my prior place of residence because they shared this approach to patient care. It is hard to stomp on patients' rights, allow them to be uneducated about their condition, and perform unnecessary procedures on them if the practioner truly believes in these tenets of care.

Sure there are some D.O.s who probably just pay lip service to this philosophy, but I would like to think they are the minority. If you have been dissatisfied with your more traditional healthcare experiences you might look into care from an osteopathic physician as an option.
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#79 of 79 Old 04-22-2008, 08:35 PM
 
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Thank you DoctorJen for your post. You are truely one who is trying to be the change that is needed. And I especially appreciate you for taking yourself out of the equation and looking at the big picture.

Every single person, whether they wish to admit it or not, knows that somehow, somewhere there are doctors and med. professionals. It's impossible that every single one be "evil."

That being said, many mamas here have YET to meet one of the docs who are wonderful. Some have NEVER met one. SO yes, their experiences are going to be jaded. Those who have will post about it. Some women have truely found wonderful OBs. They post here. Plenty of women on here have mentioned that there ARE wonderful professionals out there.

The ones who have never met one, a ped, an OB, whatever, can only base their views on what they've experienced. It's a little hard to throw in a disclaimer if you've honestly never experienced anything else. These women need to be listened to and learned from, especially if you feel that you are trying to be the change that is DESPARATELY needed. It's not about YOU, it's about the profession as a whole. The profession as a whole, and it's treatment of patients, especially in OB and Peds, needs major overhaul.

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