Thursday, December 18, 2008

More on the medical profession

Dr. Pauline Chen asks in the New York Times, "Do patients trust their doctors too much?" She discusses how patients rating their doctors tend to rate almost exclusively based on the doctor's attitude. Are they nice, attentive to questions, not too rushed? There is little comment on the actual quality of medical care. She sees this as trust - that patients trust that all doctors are providing them equally good medical care. I would frame it differently - that patients have no way to compare and assess medical care, the way they can the work of other professionals like roofers. Does the roof look good? Are the materials quality? People feel well-equipped to assess these questions. But to take stock of your doctor's care - did she prescribe an expensive new drug or the cheaper and just as good generic? Did she order tests you needed, or skip them? People don't know and don't feel equipped to find out.

I have met many women who trusted their OBs because they were "nice". Sometimes I have gently tried to question something, only to hear "He's very nice and I trust him completely." I think you should choose trust your care providers, but not because they are nice, but because you have equipped yourself to assess their care skills and how well they can assist you in having the safe, healthy birth experience you want. How do you equip yourself? First, you have to decide what birth experience you do want and then, you have to do a lot of research and ask a lot of questions to find out who that provider in your community is. Talking to other women who had similar hopes for their births, asking doulas and other people in the birth community for recommendations, and interviewing more than one provider are all key. Just deciding that your "nice" gynecologist will be the one who delivers your baby is unlikely to match you up with the exact care you want, especially if you are hoping for a low-intervention birth. If you ask the tough questions when interviewing and forge a respectful partnership with your provider, you will be able to truly trust her or him, and not need to worry about fighting for your wishes during labor.

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