Pregnant? Check your skepticism at the door.

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By Jill—Unnecesarean


I’m going through a phase in which patient safety/ patient empowerment literature keeps falling into my lap whether I like it or not. Thank you to those of you who have sent me your books and told me about your blogs. Thank you to the random person who left their copy of a book about how to avoid being the victim of medical blunders on that picnic table.

We’ve had some interesting discussions on the Facebook fan page in the past few weeks about the overuse of medical care which are starting to steer toward why the concepts of the empowered patient, the informed consumer or participatory medicine seem to elicit minimal public outrage when talking about anything but maternity care. The short article Most U.S. Physicians Practicing ‘Defensive Medicine’: Survey indicates they order more tests, procedures than necessary came out last month, which featured a link to Navigating the Health Care System: Asking Questions About Medical Tests. I’d say that a lot of fan page members thought the last letter to the editor listed here was just delightful, especially the part when Random Lawyer D00d grumbled about how the “natural birth fetishists” could now choose dangerous vaginal birth after cesarean.

In response, reader Sharon remarked on the fan page that a family member chose two months of bed rest followed by intensive physical therapy to treat a slipped disk instead of back surgery. Sharon is pretty sure that no one called her a natural spine fetishist. Maybe she just didn’t hear the people gossiping about how her sister in law was incredibly selfish and overly concerned with the experience because she preferred the metaphysical benefit of a “natural” recovery of her spine. No, seriously. I heard recently that women really want vaginal births because they think there’s a metaphysical advantage over cesareans. Diagnosis of hysteria, anyone?

I would be lying if I told you that I’ve never perked up upon hearing pleasant sounding buzzwords on the news like “efforts to reduce number of surgical procedures” and “cost-effectiveness” and “patient safety” and “quality indicators” and “patient empowerment” and “navigating the health care system” and “when to get a second opinion” and so forth. Really, what’s the difference between trying to avoid overtreatment as a pregnant woman and trying to avoid it as an orthopedic patient? The orthopedic patient with too many questions will simply be labeled annoying or a pain-in-the-ass (as seen on comments on KevinMD) by doctors, yet labeled a proactive consumer on feel-good, three-minute local news segments. However, a skeptical pregnant woman with similar questions or concerns about overtreatment and their local hospital’s 49% cesarean rate seems to gets a different label, and it’s usually not something respectful like “rational, educated consumer.” Straw man arguments are clearly more fun in that they appeal to the lowest common denominator and, as a sexy bonus, they divert attention away from said 49% cesarean rate at one’s local hospital. Denying that there is a problem may spit-shine a few egos but it has no benefit to patients.

Keep talking about your overtreatment or misuse of medical procedures, my friends.  



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The Treatment Trap: How the Overuse of Medical Care is Wrecking Your Health, and What You Can Do to Prevent It