Hello All, Thought you might like to see an article that was in the paper today.
I particularly liked the broad reference to the B Mid. Cheers for now Fiona 'Obstetrician fed up with the hostility' GRAHAM COOKE One of Canberra's most experienced obstetricians and gynaecologists has decided to retire, partly because of what she sees as a growing hostility between doctors and patients. Heather Munro also has "real fears" for Canberra Hospital, which, she says, is rapidly losing its senior expertise in her field. In 25 years of practice in Canberra, Dr Munro has delivered thousands of babies and treated the ailments of generations of women. In recent times, she has detected a "change of atmosphere". "I believe it is good that patients keep themselves informed and I have no problems about them questioning what we do, but some are becoming really hostile and refusing to discuss the issues," she said. "The kind of retort I have been getting is 'you are saying this because you are the doctor and I'm not going to believe you'. I find that quite demeaning and it is not the way I want to practise." She said a patient put the point succinctly. "She was a schoolteacher and said that if I came into her classroom and told her what to do she would be mortified and angry. Teaching was her experience, obstetrics and gynaecology are mine. "These days patients get fed a great deal of information. There is a lot available on the Internet, some of it very good, some totally biased to a particular point of view." One of the decisions that had to be left to the obstetrician was when to intervene in a birth. "Nature is not always the best midwife and sometimes intervention is right, obviously so in cases of hypertension and breech," she said. "Unfortunately there has been a lot of antipathy between midwives and some doctors, and the press have loved it. There are a lot of good midwives in Canberra, but there are some who do not realise their limitations. They can't do everything, and caesarean sections are an obvious example." She had reservations about new procedures that would allow young people to go straight into midwifery without first doing general nursing. "It is fraught with complications; there is a lot which midwives must know which comes from general nursing experience of things like diabetes and hypertension." Dr Munro's retirement as an active practitioner will be total. "I can't do part-time work because the moment I deliver one baby I have to pay a full years' fees for insurance against litigation. Last year I paid $60,000 and this year it would have been $90,000. So my expertise is simply not available. If I give one opinion and something goes wrong I could be sued. "The ACT has some special problems. We have a lot of older mums who are purposely conceiving later in life, and that does produce a higher rate of complications. In addition, complicated pregnancies are drawn from the region. "This is something which will have to be addressed before it becomes uneconomic to practise. We need a fault scheme as exists in New Zealand. "One of the great difficulties in our system is that the plaintiffs do not do well out of it, nor do the doctors . . . only the lawyers benefit. "If they do win a large payment, even after the lawyers have taken their fees, they don't get much advice about how to stretch it out over the rest of their lives." Her expertise as an administrator and policy-maker will continue to be utilised through her work for the Medical Board of the ACT, which she chairs. She is also a member of the Australian Medical Council. "The board deals with registrations, which are largely routine, but there are also programs to assist doctors with problems, and there is a complaints unit for patients." The council was originally set up to judge the qualifications of overseas-trained doctors, but has since widened its brief and is now looking at standards in medical schools and colleges. In recent years she has practised at John James Hospital, having decided she did not like the direction Canberra Hospital was taking. "I really feel for Canberra because most of the senior staff in obstetrics and gynaecology have either resigned or are working out their notice. It was interesting that when I resigned no-one bothered to ask me why." __________________________________________________ Do You Yahoo!? Send FREE video emails in Yahoo! Mail! http://promo.yahoo.com/videomail/ -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
