Quote of the Day: Doctors are Scared to Change Practice Patterns

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“…[T]he increasing rate of cesareans is “a complex problem. The first issue is that doctors are hesitant to change their practice patterns — even when it’s been shown that what they’re doing is wrong. The second problem is a fear of malpractice. Doctors believe that if something goes wrong and they get sued, the best defense is being able to say, ‘I did a cesarean as soon as possible.’”

-Norbert Gleicher, M.D., Parents Magazine, January 1988

  

In the last twenty years, this concept has been deeply buried under collective denial, both among medical professionals and the general public in the United States. In the two decades since this article was published, the fear of change led to a defensive mass denial of the problems with excessive cesarean sections. It took fewer than two decades for the onus to be slowly taken off of doctors through persuasion, PR, deceit and the public’s willingness to believe what they hear reported on the news and told to them by their doctors.

Now the overuse of the cesarean section is the fault of women. They needed it. They wanted it. They will all sue us if they don’t get what they want. We doctors are simply innocent pawns, altruistically responding to society’s demands.

Women suffer as a result of the behaviors stemming from the actualization of cultural myths within the obstetric community, whose privilege and authority as medical practitioners in American society allow for these myths to achieve acceptance from society at large. Ultimately, their unique skill set and valuable contributions to women’s health are becoming squelched by the iatrogenic injuries they feel justified and righteous in inflicting.

I don’t know if they really think they can lie and blame their way through this forever. They’re lying to themselves as much as they are lying to the women they care for and to the American public.

Change. It’s good for you. Besides, you’ve forgotten what you’re really afraid of… and it shows.

 

 

 Here is the original press release issued by Parents Magazine to promote their January 1988 issue: 

Rapidly rising cesarean rate due to reluctance of M.D.s to change even erroneous practices, fear of malpractice: noted M.D. (Norbert Gleicher)

NEW YORK, Dec. 15 /PRNewswire/ — More and more unnecessary cesarean sections are performed each year (the rate for all quintupled since 1967) because of doctors’ reluctance to change even erroneous practice patterns, fear of malpractice, and the mistaken assumption that all women who’ve had a cesarean must have them again, asserts the chairman of OB/GYN at Chicago’s Mt. Sinai Medical Center who suggests decreasing the cesarean rate to “6 to 10 percent (instead of the current 25 percent) would be about right to maintain a decreasing perinatal mortality.”

Norbert Gleicher, M.D., states in the current (January) issue of PARENTS MAGAZINE that the increasing rate of cesareans is “a complex problem. The first issue is that doctors are hesitant to change their practice patterns — even when it’s been shown that what they’re doing is wrong. The second problem is a fear of malpractice. Doctors believe that if something goes wrong and they get sued, the best defense is being able to say, ‘I did a cesarean as soon as possible.’”

Gleicher, commenting on the fact that 94 percent of women who have had one cesarean deliver subsequent children the same way, notes, “We’re known for years that a large majority of women don’t need repeat cesareans. Yet nationwide, only a very small number of women are even given the chance at a VBAC (vaginal birth after cesarean). It’s beyond me how that’s possible. What’s going on is simply bad medicine.”

There is, according to the article, “new evidence that babies benefit from the actual process of labor.” It cites Swedish research that found babies born after labor have higher levels of stress hormones than babies born by elective caesarean. “These hormones — called catecholamines — help a baby’s lungs mature, regulate body temperature, and send blood to the brain and heart. This may partially explain why cesarean babies are at a far greater risk of suffering from symptoms of respiratory distress than babies who are born vaginally. Not only does the normal stress of labor help the baby, but the physical process of moving through the birth canal squeezes fluid from the baby’s lungs and helps its prepare for life outside the womb.”

 

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