"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

“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.

Monday, May 10, 2010

More absurd secrecy?

First, I admit I only heard about this through an email blast this weekend from L. Janel Martin. The details are sketchy but all too hauntingly familiar for me to ignore. Dr. Robert Biter from the Carlsbad, CA area has apparently lost his admitting privileges at Scripps Encinitas Hospital:

As of 5 pm Friday, May7th, Dr. Biter's privileges to deliver babies at Scripps Encinitas Hospital have been suspended. He will still be able to see his current patients postpartum (after they deliver) in the hospital. He is hoping that this will be resolved quickly & is working hard to ensure that there is a backup plan for his patients that are due to have their babies soon.

Here's what I know: There have been no obstetrical malpractice issues against him---ever. The hospital, specifically some OBs, have been attacking him for the last 3 years for protecting women's rights for natural birth. I believe it''s all out of greed for money--less interventions means less money for the hospital. Other doctors were losing their patients to Dr. Biter because they wanted a doctor who would support them & that trusted birth as being a woman's birthright rather than a medical procedure.

An effort to support him is being organized by Carol Yeh-Garner at:

Carol Yeh-Garner
3192 Corte Tradicion
Carlsbad, CA 92009


My own experiences suggest that the rules of peer review and the convenient veil of confidentiality will prevent us from knowing the real reasons for the hospital committee's actions. However, I do suspect that Carol's suspicions are likely correct. What we can do, if Dr. Biter so desires, is contact and barrage the hospital administration with calls and letters asking them for explanations. The one thing that hospitals hate most is negative publicity in the media and having a light shone on their internal policies and politics. If you have any information, please comment here on my blog to educate the rest of us. Also, for those who care to write here is an address:

Write a letter to the CEO of Scripps Encinitas:
Chris Van Gorder--President & CEO of Scripps
4275 Campus Point Court
San Diego, CA 92121

I have heard that Dr. Biter is planning to open a free standing maternity center supportive of the midwifery birthing model. The timing of this latest absurdity against him cannot just be a coincidence. I am hopeful that we will know more soon. Although, he may be restricted from discussing this openly by the rules of the hospital set up to always favor the hospital. Through my own experience I find such secrecy, when not directly involving patient confidentiality, to always be suspicious of nefarious reasoning. Dr. F

No comments:

Post a Comment