It seems there are some rumblings about ready to spill over at my hospitals in Ventura County. Wouldn't it be nice if everyone involved could speak honestly about what goes on there behind closed doors. With all the secrets and suspicions and threats one might think that national security was on the line. To me it is a ruse the powerful play to make what they do seem so almighty important. Its the doctors and nurses and midwives that are saving lives and yet its the administrators and lawyers that act as if only they carry the burden of righteousness.
This past week I was called into a meeting with the Chief of Staff and the Chairman of my OB/Gyn department. Four weeks ago and almost 10 months since the investigation into my practice which started me on this whole blogging thing began the decision was made as to whether further disciplinary action should end or continue. It took more than 2 weeks for their lawyer to draw up a letter and another 10 days before a mandatory meeting was called. So they knew for a month about my fate but because of the way an administrative system "works" could not express any humanity by letting me know sooner. I arrived for the meeting early while the other parties were 25 minutes late. No apology was offered. I was handed a letter exonerating me from any wrongdoing and ending any investigation. That was it!
Yes, they had me sign a piece of paper saying I received the letter. Ever heard of certified mail? No explanation or apology offered as to why they sat on this decision for a month. Clearly, to me a total lack of concern or empathy for what I might be dealing with. Then we had a discussion about making sure professional conduct rules were followed and the problems with our department came up. Clearly, the Chairman of my department and I see things differently and it was enlightening to see how little truthful information gets filtered through to the Chief of Staff. Hidden behind those rules of confidentiality is an ugly process by which the powerful can pick on and destroy those with which they take issue. Despite the lack of courtesy, I feel fortunate that I am now out from under their threat. At least for the moment. With the ACOG review panel coming in 2 weeks to scrutinize this OB Department there are some of us who hope a day of reckoning will come. And maybe, when the balance of power shifts to those who lead justly and with reason we may again see things like Midwives in Camarillo, breech deliveries and even a way to bring back VBAC.
Now, the horrible news. Sadly, the committee did claim one most wonderful and innocent victim this past week. After almost 3 years of tormenting one of my colleagues and a patient and nurse favorite they called her in to administration Thursday afternoon and suspended her from the staff. What I believe to be a series of lies, distortions, discrimination, pettiness, fraud and ethical violations by certain members of the OB Dept. all went against her. Complicit in the process are numerous administrators and other physicians who never took the time to look deeper and question the motivation and conflicts of interest of those that persecuted her. And to all of the staff not privy to the "confidential" information there is a feeling of sadness and astonishment that this could happen. Those of us that work with her know her to be caring, competent and appropriate in all she does. So we cannot understand the WHY? She has no greater incidence of complications or bad outcomes. In fact, compared to the members of the committee who led the charge to remove her she has a far better track record.
For reasons none of us can comprehend she now faces an inquiry from the Medical Board of California and will likely never again be able to perform hospital based deliveries. It is very unlikely that once you are kicked off a medical staff at one institution that any other will allow you onto their staff. However, on the positive side she has immense support and good friends. With ACOG coming to investigate we may have some light shown on what really happened. Interesting timing of suspending her 2 weeks before ACOG comes so that now she does not have a chance to speak to the panel as a member of the department. But her voice will be heard. Also, now that the one-sided administrative hearing process is complete she does have the opportunity to appeal in civil court where there will be an impartial judge, subpoena power and a jury made up of civilians free from subterfuge. Having sort of been through this type of process myself, my heart aches for the fear, anxiety, helplessness and unrequited anger she must be feeling. I think she knows how loved and supported she is and those that have hounded her will have their day of reckoning and right soon.
How I long for a simpler time where honest men went into medicine for a single purpose of helping others. How that time was lost is a subject for a great novel at some point. When I see what has happened to Dr. Biter, my colleague, many midwives and myself to a lesser degree I want to cry for a moment and then I am energized to fight back to reclaim common sense and hold those who would abuse their positions accountable and liable. The peer review system is so broken at my institution and the undercurrent of discontent with those that abuse it and support it in its current form is about to explode. Sad, that it will take outsiders and the civil court system to make transparency and honesty happen. But happen it must! Dr. F
"All that is necessary for the triumph of evil is for good men to do nothing" Edmund Burke, 18th century Philospher.
"A long habit of not thinking a thing wrong gives it a superficial appearance of it being right." Thomas Paine
"The welfare of humanity is always the alibi of tyrants." Albert Camus
"Choice is the essence of ethics: if there were no choice there would be no ethics, no good, no evil; good and evil have meaning only insofar as man is free to choose." Margaret Thatcher, March 14, 1977
"A long habit of not thinking a thing wrong gives it a superficial appearance of it being right." Thomas Paine
"The welfare of humanity is always the alibi of tyrants." Albert Camus
"Choice is the essence of ethics: if there were no choice there would be no ethics, no good, no evil; good and evil have meaning only insofar as man is free to choose." Margaret Thatcher, March 14, 1977
“It is difficult to get a man to understand something, when his salary depends on his not understanding it.” ― Upton Sinclair
Explaining the Cause
I am a practicing obstetrician who is a strong supporter of patients rights to informed consent and refusal. I believe a patient has the right to choose her own path given true and not skewed informed consent. Following that tenet, just as a woman should be able to choose to have an elective c/section she should be able to choose not to have one, as well. The American system of hospital based obstetric practice has been eroding those choices for women for quite some time. Due to concerns of economics, expediency and fears of litigation women are being coerced to make choices that may not be in their best interest.
I have had a long relationship collaborating with midwives and find the midwifery model of care to be evidenced based and successful. I was well trained at Cedars-Sinai Medical Center in the mid 80's to perform breech deliveries, twin deliveries, operative vaginal deliveries and VBACs, and despite evidence supporting their continued value, hospitals are "banning" these options. Organized medicine is also doing its best to restrict the availability of access to midwives.
Home birthing is not for everyone but informed choice is. Medical ethics dictates that doctors have a responsibility and a fiduciary duty to their patients to provide true, not skewed, informed consent and to respect patient autonomy in decision making. Countries with the best outcomes in birthing have collaboration between doctors and midwives. This is not what has been happening in the hospitals of America. Its time for a change and the return of common sense.
The midwifery model of care supports pregnancy as a normal function of the female body and gives a legitimate and reasonable alternative to the over-medicalized model of birth that dominates our culture. Through this blog I hope to do my part to illuminate what is wrong with our maternity care system and what is right with it. I do not expect all to agree and that is OK. We must all understand that given honest data it is not always reasonable to expect two people to come to the same conclusion. Our differences should be respected.
I have had a long relationship collaborating with midwives and find the midwifery model of care to be evidenced based and successful. I was well trained at Cedars-Sinai Medical Center in the mid 80's to perform breech deliveries, twin deliveries, operative vaginal deliveries and VBACs, and despite evidence supporting their continued value, hospitals are "banning" these options. Organized medicine is also doing its best to restrict the availability of access to midwives.
Home birthing is not for everyone but informed choice is. Medical ethics dictates that doctors have a responsibility and a fiduciary duty to their patients to provide true, not skewed, informed consent and to respect patient autonomy in decision making. Countries with the best outcomes in birthing have collaboration between doctors and midwives. This is not what has been happening in the hospitals of America. Its time for a change and the return of common sense.
The midwifery model of care supports pregnancy as a normal function of the female body and gives a legitimate and reasonable alternative to the over-medicalized model of birth that dominates our culture. Through this blog I hope to do my part to illuminate what is wrong with our maternity care system and what is right with it. I do not expect all to agree and that is OK. We must all understand that given honest data it is not always reasonable to expect two people to come to the same conclusion. Our differences should be respected.
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