Wednesday, May 21, 2008

Politics in Local Medicine

This really irks me. As I understood the situation (from the inside gossip to which I used to be somewhat privy) this has everything to do with her lower than average c-section rate. At least it did when Alaska regional Hospital withdrew her privileges three years ago while I was working in another private practice in the same hospital. I can't imagine that it's any different in this situation.

What is most absurd about the whole thing is the level of patient satisfaction her patients have with her. They LOVE her. I have heard that echoed time and time again. More than that, I know some of her patients personally, and they love her. Not only that, in addition to be loved by her patients and having a lower c-section rate than the average OB-GYN in Anchorage she also has a low rate of complications. Those two things when combined equal nothing more than a good thing. It's good for her as a provider, it's good for her moms and it's good for their babies.

Everyone is excruciatingly aware of the overly high rate of cesarean deliveries in this country. It is also no small secret that a huge proportion of these deliveries, when not done at the mother's discretion for her convenience, are done out of fear of a malpractice suits. This fear of lawsuit is frequently what requires a woman to have a repeat c-section. That is a woman who has once delivered via c-section has been required, by most of the medical dogma and standards for the better part of the last 30 years, to deliver all subsequent babies by c-section instead of being given the option to deliver vaginally. (Known as a VBAC- Vaginal Birth after C-section) At one point in time, when different incisions were used to deliver c-section babies, the risks were greater. Things have changed though.

Doctors and malpractice insurance carriers are scared of the complications that might arise from a VBAC. But really there is a lot of hard science and positive statistical evidence to indicate that there is little to no greater risk for a VBAC than for a first time vaginal delivery given an otherwise normal and healthy pregnancy.

Colleen Murhpy's privileges being revoked amount to simple politics. C-sections make a lot of money for hospitals and they also keep the malpractice bogey man at bay in the minds of some risk assessment and abatement professionals. The medical community in Anchorage can't handle another provider who offers the same services as they do, with a similar complication rate...but without the need for as much medical intervention. It makes those other providers look bad (and doesn't make as much money for the hospitals.)

This is a huge disservice to Dr. Murphy's career, and more importantly to the women who have chosen her as their provider. If her privileges are completely revoked at both major hospitals in Anchorage this will leave all of her patients without the provider they selected, and have come to know and trust, to be at their deliveries. It's disgusting.

I think it's time for some letter writing. Letters to the editor, letters to the hospitals and letters to the sate medical board. Hopefully her patients have the same idea as they are the best suited to be vocal supporters of Dr. Murphy during this time.

I should add that I don't actually know Dr. Murphy, aside from having met her once or twice. I'm sure she has absolutely no idea who I am...

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