Friday, June 08, 2007

I need to blog about something big

I guess this borders on political. It's about as "universal" as I get on this blog...

Why...why...why...WHY is it considered OK for a doctor to diagnose ANYTHING over the TELEPHONE?!?!?!

Let me back up here. In case you don't remember, in the weeks leading up to Alex's death, I SAW my OB and my regular doctor in person. They both misdiagnosed my uterine infection as an upper respiratory/sinus infection. I CALLED to complain that the course of treatment (OTC decongestant and tylenol) was not working. I KNEW something was wrong (though I did not know it was related to the pregnancy) and nobody would listen to me. Now I'm pregnant again and, admittedly, I am much more cautious.

But I can not get over the number of women on the internet 'pregnant after loss' message boards who are willing to have their doctor 'reassure' them over the telephone. We're talking women who notice movement changes in their babies. We're talking women who have bleeding. We're talking women who have classic symptoms of gestational diabetes or iron deficiencies or other issues that need management/treatment

And yet, when these women express their feelings, the repeatedly qualify them with, "I don't want to make a fuss over nothing." They call their doctor and when their doctor tells them there is "nothing to worry about," they accept that...without EVER BEING SEEN! As if their doctor has some magical diagnostic ability over the phone lines.

Now I don't want to create mass hysteria...but this is INSANE! In NO other area of medicine (that I am aware of) is it acceptable to diagnose someone over the telephone. So why is it ok during pregnancy? What are we accomplishing by consistently downplaying our fears? by patting women on the head and telling them not to worry (their pretty little heads)?

I'll tell you what we are accomplishing...A great game of Russian roulette...with our babies' lives. The odds MAY be in your favor and you will MOST LIKELY be ok. But MY GOD...why take that chance?!?!

Let me tell you one thing, if you are unlucky enough to get that one bullet right in the will wonder the exact same thing I am wondering now. And then it will be too late.

But even more interesting is the fact that this is a group of women who are pregnant AFTER LOSS. You would think they would be much more careful...much more demanding...of the medical treatment they receive.


Aurelia said...

In Ontario, Drs. are not supposed to diagnose over the phone. They can discuss something with a patient, like changing dosing of a medication, or renewing a medication, or even giving test results, and ordering more tests,, "We've found bacteria in your sample, so I'm phoning a prescription in."

But this?

Not supposed to happen, and frankly, I don't understand why Docs ever do this. Especially for pregnant women, it's so easy to say, if you are nervous, come into triage and get checked.

And we wonder why liability insurance is so high? Maybe because Docs just aren't cautious are completely right Catherine. I just don't get it either.

AmyO said...

I believe I'm a lucky one when it comes to doctors. My OB office is wonderful. I will admit they told me to stop reading with my first pregnancy which resulted in my first live daughter, but after I lost my 2nd daughter at 18 weeks and became pregnant again they allowed me to come in whenever I want. If I felt less movement if I just wanted to check the heartbeat they were faboulous. However, you need to stand up for you and your child. And with this last pregnancy (#5)they knew my history and started testing me b4 my first official OB visit, unfortunately I lost the baby this Wednesday and had my D&C today but my docs are wonderful. Sorry for the ramble. I needed to share.

kate said...

I have never been told by my doctor that "there is nothing to worry about" I love my doctor! On the other hand we live in a major metropolitan area with an absolute abundance of health-care choices (for those with decent insurance, ahem). I have an online friend who is getting what i (and she) consider substandard care in her very complicated sub pg, but because she is in a small town, that is the best she can get, apparently. :(

Elizabeth said...

I've gotten "it's probably nothing" from my doctors, but it was always followed by "come in and see me just in case."

*Darcie* said...

I completely understand where you are coming from Kate! My dr here and in Topeka are both wonderful...they know that if I am calling about something I am worried about, then they should check me!! They know that I dont fool around...I dont blame you for talking about is a very good point!!!

Julia said...

My OB is all about let's check it out. I already know that in the sub pg I will be at their offices 2-3 times a week towards the end, and any time I feel like it before then.

It's strange, but many women think that they can't or shouldn't argue with their doctors. I had friends tell me before going to deliver their first that "I'm not going to argue with a doctor" about things like breaking their waters. I never understood that. When I was delivering Monkey, I told the doctor who wanted to break my waters after only an hour in the hospital during which I progressed nicely to go think about that in the hall. And I have no compunction about raising fuss. I was raising it in my pg with A, and my doctor was very accommodating. Turned out I was barking up a wrong tree, and a completely unexpected thing got him, but I tried my damnest.

More than anything, though, it sucks that doctors like that exist. Do they not know that babies die? Or get very sick? Do they want something like that on their conscience? Sorry, I just don't get it.

GLouise said...

Wow, that is really just incredible...

Depressionista said...

The day I lost my daughter (almost exactly four years ago) I called the major university hospital in my town to tell them I was bleeding heavily at nearly 22 weeks pregnant. The resident told me to stay home because it was probably nothing. I then told her that I was basically calling just to let them know I was coming in, so get ready for me.

I completely agree with you, and while I agree that women have a responsibility to themselves and to their babies, I feel the real fault lies with the doctors, residents and other health care "professionals" who feel they are providing adequate care by doing phone consultations about pregnancy complications. When a patient calls up with a problem, the DOCTOR is the one who should be insisting on the patient coming in. It shouldn't all be up to the woman.

Good post.