Friday Meeting - My Take

So, met with the chief of staff, current and future as well as the head of the OB committee today. Bottom line is the OB committee does not want me to even offer the option of elective VBAC or vaginal breech delivery to women at either campus. If I were to agree to this then they seemed to suggest the disciplinary action might just go away. This is going to be a dilemma for me. An intolerable situation facing many private practice physicians today. Compromise your values to pay your overhead or compromise your practice to keep your values. In the meantime they are supposed to reinstate the midwives but I suspect it will not happen until early next week.

One thing was made clear to me today. The hospital believes the OB committee is the final arbiter of standards in this community and since none of them would offer a breech delivery then for me to do so is beneath the standard. Good outcomes and innovation are not relevant. They also essentially said that skewing your informed consent process is OK because allowing patients the option of VBAC affects other personnel such as anesthesia, peds and nursing and puts them at risk. While I do see their point, they did not want to hear that the patient has rights and is the one we are supposed to serve. There was no place for discussion of the risks of repeated c/sections or evidence supporting our midwifery model today. That was my take anyway. Will keep you posted.