[Elena]

The recent debates about hospitals and physicians have made me start thinking. I've seen many women on here talk about how horrible it is that doctors and hospitals exert some control over a woman's birth experience. I tend to think that people are a little too hard on them. Hospitals and doctors have been backed into a corner by the insurance companies. I believe some of this is strictly the greed of the insurance company, while part of it comes from frivolous lawsuits. Many hospitals, like the one I used to work at, run on razor thin margins. If they allowed something that the insurance company wouldn't support and got sued, they could easily go bankrupt.

It's just as hard for doctors. Doctors pay insane amounts of money for malpractice insurance to protect themselves. I remember reading once that 75% of obs are sued during their careers! I have a very hard time believing that 3/4 of obs out there have messed up so badly. While I'm sure that happens some of the time, I think more often it's parents suing because they didn't have the birth experience they expected. (We have a tendency to forget that birth, while natural, is also precarious. Many things can go wrong that are nobody's fault, but people are still looking for someone to blame.) I also imagine that if a doctor went against hospital policy, even if it was what the woman wanted, he could lose his license. (or priviledges at that particular hospital which would be very damaging to his practice.)

So what does everyone else think? Do hospitals and doctors get too much criticism for putting restrictions on labor and delivery? Are insurance companies more responsible? Did we, as americans, partially bring this on ourselves by living in a society where it's considered acceptable to sue for huge amounts of money whenever something goes wrong. (even if it wasn't the doctor or hospital's fault)

I'm looking forward to everyone's thoughts.

Part of me wants to agree with you, but unless hospitals have similar universal policies, its hard not to see some of their rules as arbitrary. What I'm dealing with right now is one hospital that has standard procedures and regulations placed on all mothers, regardless of individual situations. The hospital 3 blocks away, with the same facilities, serving the same population base has none of those procedures as standard. Why is it dangerous to eat a sandwich during labor in one hospital, but deemed safe and ENCOURAGED at the other hospital?

[Lash]

^ agree with cori, going to think on what to add but short on time...
I dont think you can EVER be too hard on an institution where your health and LIFE is in their hands, where they have taken much of the power and decision making rights, and where you are still the consumer~

[Elena]

Why is it dangerous to eat a sandwich during labor in one hospital, but deemed safe and ENCOURAGED at the other hospital?[/b]

I understand what you're saying and it is very frustrating to find something allowed at one hospital and banned at another. I wonder if the hospitals each use a different insurance company?

Interestingly enough I just found a New York Times article that adresses this very issue. It just reinforces my belief that insurance companies, and lawsuits, are mostly to blame for these sorts of problems.


RISE IN INSURANCE FORCES HOSPITALS TO SHUTTER WARDS

[Lash]

i agree, and I am not anti hospitals, I think there is a much larger network type problem going on
as a therapist, i TOTALLY understand the problems caused by insurance. Often I can see an individual but not the couple, the child and not the mother, and i am forced to give a diagnosis just to see the person, even if I dont think they meet criteria. Not eveyone that needs some assistance or empathy has a mental disorder or diagnosis yet the insurance companies force us to give a label or they dont pay for services

[rdhdtrue]

It is actually very sad how doctors have to worry so much over law suits.

Dani's cardiologist just said that he did not think a certain operation she was going to have was needed but could not say that until the American Heart Association came out with a study in April to back his opinion.

[Banned-Mommieof3]

ITA with everything Elena has said thus far.

[glasscandie]

I'm pretty much a moderate on this subject...I'm not gung-ho pro-hospital because there are faults there, and I'm not gung-ho pro-homebirth because there are faults there as well. I had a great hospital experience, so I can't even compare it off of that.

But, I do think that people (not just in these debates, but in general a lot of the "crunchy" people I meet) can get a little militant about subjects like these, and forget that doctors and hospitals aren't doing these things to piss you off, or make your life harder than necessary, or even because they want to - but because they have to, for whatever reason (lawsuits; maybe they have an overcrowded OB wing and need to get people in and out, whatever). As for things that are OK in one hospital and not in another, it again probably comes down to something as stupid and frivilous as a lawsuit. Maybe someone ate something, had an allergic reaction while in labor, and her baby died; or maybe a laboring woman ate something, started to vomit, and got severely dehydrated; maybe it's because they run a larger than normal high-risk OB ward and have a higher chance of c-sections. You're generally not supposed to eat when you undergo any type of anesthesia.

[flygirls2]

I agree with the OP.

^ agree with cori, going to think on what to add but short on time...
I dont think you can EVER be too hard on an institution where your health and LIFE is in their hands, where they have taken much of the power and decision making rights, and where you are still the consumer~[/b]

You have a choice to go to any facility(or lack of) that you want. I don't think it's anyone's issue what one hospital chooses, and another does not. Other companies run their businesses the way they feel comfortable, as do healthcare facilities.

But, I do think that people (not just in these debates, but in general a lot of the "crunchy" people I meet) can get a little militant about subjects like these, and forget that doctors and hospitals aren't doing these things to piss you off, or make your life harder than necessary, or even because they want to - but because they have to, for whatever reason (lawsuits; maybe they have an overcrowded OB wing and need to get people in and out, whatever). As for things that are OK in one hospital and not in another, it again probably comes down to something as stupid and frivilous as a lawsuit. Maybe someone ate something, had an allergic reaction while in labor, and her baby died; or maybe a laboring woman ate something, started to vomit, and got severely dehydrated; maybe it's because they run a larger than normal high-risk OB ward and have a higher chance of c-sections. You're generally not supposed to eat when you undergo any type of anesthesia.[/b]

Completely agree.

[Lash]

I agree with the OP.

You have a choice to go to any facility(or lack of) that you want. I don't think it's anyone's issue what one hospital chooses, and another does not. Other companies run their businesses the way they feel comfortable, as do healthcare facilities[/b]

I think you have an incredibly narrow view of insurance and people's choices. Many people, often most people have no choice in either what hospital or doctor that they can use, either based on insurance/funding or location.

[AnnD]

I'm pretty much a moderate on this subject...I'm not gung-ho pro-hospital because there are faults there, and I'm not gung-ho pro-homebirth because there are faults there as well. I had a great hospital experience, so I can't even compare it off of that.

But, I do think that people (not just in these debates, but in general a lot of the "crunchy" people I meet) can get a little militant about subjects like these, and forget that doctors and hospitals aren't doing these things to piss you off, or make your life harder than necessary, or even because they want to - but because they have to, for whatever reason (lawsuits; maybe they have an overcrowded OB wing and need to get people in and out, whatever). As for things that are OK in one hospital and not in another, it again probably comes down to something as stupid and frivilous as a lawsuit. Maybe someone ate something, had an allergic reaction while in labor, and her baby died; or maybe a laboring woman ate something, started to vomit, and got severely dehydrated; maybe it's because they run a larger than normal high-risk OB ward and have a higher chance of c-sections. You're generally not supposed to eat when you undergo any type of anesthesia.[/b]

Ditto! I think most docs are out for self-preservation first. And I totally understand that being in the mental health field....I often have to make decisions that may or may not be in the best interest of the client but in MY best interest. For example, if someone expresses suicidal ideation and I deem them to be at a higher risk for it then I might have to call a friend or relative to help with a suicide watch for the client (something the client was extremely against) or even hospitalize them. This protects a client but it also protects me since I followed the necessary procedures so I don't get sued if that client were to commit suicide. Since I work for psychiatrists, I often have to "rat" out my clients and let the docs know if they have been doing any illegal drugs that might or might not interfere with the medication they are prescribing. The drugs may not even do anything but I certainly air on the side of caution so I don't get blamed if a reaction were to occur and I didn't inform the doc.

I don't think any doc can be "all encompassing"---to me, OB's and midwives are like apples and oranges. OB's can't be at a hospital delivering a baby whilst driving back and forth to a person's house delivering their baby too, it's not possible. That's why we have OB's for those who want to deliver in the hospital and midwives for those who want to deliver at home.

[flygirls2]

I think you have an incredibly narrow view of insurance and people's choices. Many people, often most people have no choice in either what hospital or doctor that they can use, either based on insurance/funding or location.
[/b]

You cannot expect every healthcare facility to conform to everyone's desires. They have a right to protect themselves in a manner that they feel comfortable doing. People always have a choice. Your insurance may not cover a CNM, but if that's what you really want--you still have that choice. If you choose to go with what is given to you, then you really cannot complain.

The recent debates about hospitals and physicians have made me start thinking. I've seen many women on here talk about how horrible it is that doctors and hospitals exert some control over a woman's birth experience. I tend to think that people are a little too hard on them. Hospitals and doctors have been backed into a corner by the insurance companies. I believe some of this is strictly the greed of the insurance company, while part of it comes from frivolous lawsuits. Many hospitals, like the one I used to work at, run on razor thin margins. If they allowed something that the insurance company wouldn't support and got sued, they could easily go bankrupt.

It's just as hard for doctors. Doctors pay insane amounts of money for malpractice insurance to protect themselves. I remember reading once that 75% of obs are sued during their careers! I have a very hard time believing that 3/4 of obs out there have messed up so badly. While I'm sure that happens some of the time, I think more often it's parents suing because they didn't have the birth experience they expected. (We have a tendency to forget that birth, while natural, is also precarious. Many things can go wrong that are nobody's fault, but people are still looking for someone to blame.) I also imagine that if a doctor went against hospital policy, even if it was what the woman wanted, he could lose his license. (or priviledges at that particular hospital which would be very damaging to his practice.)

So what does everyone else think? Do hospitals and doctors get too much criticism for putting restrictions on labor and delivery? Are insurance companies more responsible? Did we, as americans, partially bring this on ourselves by living in a society where it's considered acceptable to sue for huge amounts of money whenever something goes wrong. (even if it wasn't the doctor or hospital's fault)

I'm looking forward to everyone's thoughts.[/b]

Actually I think this is an awesome post of how "health care" is. I think you're 100% that people have given away their power and expect perfect births by Ob's and drugs. So because they sue, the insurance companies, hopsitals and doctors have to have strict procedures. Unfortunatley it's at the point where the patient, who does understand there are stillbirths that is noone's fault, have zero opinion in how, when, where and why. So yep, I think responsiblity goes all around for it getting to be strangled to this point.

On a side note, I have zero understanding how anyone can think they are getting good health care (in their based interest) based on money and insurance providers but I'm not an American so that's why it's such a foreign concept to me. Insurance companies are based on profit margins.

i agree, and I am not anti hospitals, I think there is a much larger network type problem going on
as a therapist, i TOTALLY understand the problems caused by insurance. Often I can see an individual but not the couple, the child and not the mother, and i am forced to give a diagnosis just to see the person, even if I dont think they meet criteria. Not eveyone that needs some assistance or empathy has a mental disorder or diagnosis yet the insurance companies force us to give a label or they dont pay for services[/b]

That's an interesting prespective.. It just adds salt to the wound.. I mean that it shows how money corrupts our health by having legal loopholes instead of patient care.

I think you have an incredibly narrow view of insurance and people's choices. Many people, often most people have no choice in either what hospital or doctor that they can use, either based on insurance/funding or location.[/b]