OBs, for that personal touch…

Dear Doctor:

Read. The. Chart.

Love,
Everyone

Well I can completely understand why the doc wouldn’t remember, sheesh read the dang chart before walking in and at least fake that you know her. I am sure my midwife does not remember every mother she has worked with since she has delivered hundreds, but she did recognize me and call me by name once about a year after my first birth with her when I saw her in the grocery store.

Eh, I’m not really up in arms about this one, I gotta say. I agree with the first FB comments (and being a person who’s been known to not recognize someone I’ve known for years) that hey, this guy’s got hundreds of patients that he sees for probably a cumulative hour or two over nine months, and maybe might see them again a couple years down the line. Same thing happens to school teachers, doulas, midwives, and other professionals who see lots and lots of people every day. (Heck, we want this kind of amnesia in a cop who writes us a ticket.) The fact is, especially with inductions and C-sections being so common today, unless something happened that was especially, medically extraordinary (which we’d prefer NOT to happen!) there’s probably not much reason for any one to stick out. Double checking the chart would be good, but I can totally understand this.

Hmm…bad memory, maybe. In that case, I’m with Jane on this one. It’s all right there!

I agree it’s hard to remember faces and names.
But it’s not because he sees so many women. My first home birth with my midwife was her 1008th baby. And everyone in the office knows me by name.

As for the OP, I know it’s hard to believe that the person responsible for such a momentous experience in your life doesn’t even recognize you.
That stings, and I really understand that.

I guess the issue here is really that the OB feels no need to make the effort to make his client feel comfortable, welcome, or important. Good businesspeople who want to keep their clients work hard to find ways to remember or remind themselves. Of course, the more we get away from direct client-doctor payment and decision-making, the less doctors feel any pressure to treat their clients with respect.

The issue isn’t that the Dr doesn’t recognize the Mom. It’s that he didn’t have the common sense to be polite about it. It takes 2 seconds outside the closed door to scan through her chart and realize that you were the doctor to deliver this woman’s first child. Which, agreed not a huge event in his life, would be a monumental event in hers. I’m not saying he should fake remembering her, but simply knowing you’ve met her before goes along way… What a jerk.

Here, maybe you’ll recognize my abdominal scar?

On a more serious note, I agree with the above. It would take just a few minutes to scan the chart, which he should be doing anyway. If he’s ignoring the obvious notes on the chart I would be very concerned that he could potentially miss something else down the line.

I feel bad for this Mom. Like everyone else said, he/she could have at least read the chart on the way in. My doc was alloted to me through the local hospital’s peri-natal clinic. After a delightful hospital birth with her I called her office to see if she would be my family doctor. Apparently her roster is full, but when my name crossed her desk she made the receptionist call me back to accept me as a patient because she remembered me. Our first appt she remembered the names of both my children, my husband, and details about the delivery of my son. Very cool! I realise she’s a rarity, but I’m glad to be so blessed!

I don’t blame him. I can’t remember names or faces worth peanuts.

I have several friends on Facebook that I have no idea who they are but they sent me a message to the effect of “Oh my gosh! I haven’t seen you in forever, I miss you so much!!!”

So I accepted their friend requests. lol

This reminds me of when, a couple of weeks after my c-section, I had to visit the doctor. The doctor who performed my c-section was away so I had to see the only other doctor in my small town who does c-sections, who I had never met before. He looked at me and asked “Did I do your c-section?” WTF! Shouldn’t you remember? The chart is there for a reason!

If I cut someone open, I think I would remember them… but maybe thats just me.

Of course, I give the doctor credit for even thinking he may have met the patient before. Do you really have any concept of how many pregnant women an OB at a busy hospital deals with every year? THOUSANDS. I used to work at a hospital that averaged 400 births every MONTH. Do you have any idea how many of those births are long inductions that end in a c-section? Way too many. It’s not a unique story, sadly, and it’s not one that would stand out among the hundreds of others just like it. I’m sorry, but that’s the truth.

I bumped into someone in the store recently. She recognized me and happily chattered about her baby, who she was sure I would remember because I was the nurse at her birth 8 months before and I exclaimed over how much hair her baby had.

I had no idea who this woman was. I’m thrilled that she has such a positive memory of me, and that I helped make her birth so much better. However, I assisted with more than a hundred births last year and I don’t remember everybody. I don’t remember most people, I remember snippets and bits and pieces but I don’t remember everyone’s story or everyone’s birth.

An OB isn’t going to remember everyone any more than you’re going to remember everyone. They’re human. Give the man a break.

I agree with the other people here – I don’t remember names/faces well at all. I am a college professor. If I have an appointment with a student – I look up their information and refresh my memory so I look like I remember them – even if they wouldn’t have been familiar in the wrong context. This explains why, when I run into my students out of context (say, at the grocery store) I am completely flummoxed.

Social worker here and I say I agree with alot of the posters who say it’s not abnormal. I work very hard to never think about my clients/patients outside of work. I don’t remember names. I have files on everyone and if I’m meeting with them I briefly review their file. I do not remember who your Aunt Jackie is or why you hate her so much unless I review your file. It’s not that I am a bad clinician or uncaring. On the contrary I have been told I am wonderful, and I care alot. It does not mean I have to perseverate over all of my clients and remember all of their details. It is actually very unhealthy to do so. For me it would cross some boundaries, and if I had any professional with a decent amount of patients who remembered every detail, I would run the other way. Clearly that person is way too involved, and has some issues with boundaries and I would be concerned about transferrance and countertransferrence, along with their ability to be objective.

I do agree he should have taken the time to review the basic information before the visit. That IS very important and should be expected.

GranolaRN brought up a good point. It doesn’t say that this was her OB from the previous pregnancy, just that he attended the birth. So if she was a new patient at his practice, it may not say in the chart who did the c/s.

Now if this was her OB from the previous pregnancy, do I expect him to recognize her at the store? No. But he should at least read the chart before he goes in the room.

I agree that it is vital for good relationships to review the chart before walking in a room, but often we do not have that luxury, especially outside the office.
I work in a small town, and run into women constantly who know me, but though I usually recognize their face, I am often unsure whether I delivered their baby, cared for their dying mother, attended their miscarriage, or diagnosed their STD.
We see hundreds of women every week and I deliver hundreds of babies every year, and the uncomplicated ones often blur together. An experience that for the woman may be one of the top 10 most memorable ones of her life, may be one of a thousand for us, especially if everything goes as planned.
Now, there are some folks who have really amazing memories and they are often very popular as a result, but sadly I am not one of them, which is why I rely on my charts, textbooks, notes, etc to fill in the gaps.
I know its hard for patients to understand, and we often wish we had time to develop deeper relationships with them, but the realities of practicing in the US today often precludes this.
This is one of the reasons why I think midwives do such a great job for healthy women. They are able to spend more time with each individual and address the psychosocial needs better than most MDs.
So please understand that we don’t mean to be so rude, but we’re often doing the best we can!

Dr. Dorn – Thank you for the insight and I have to say, it always makes me smile when a doctor says he supports midwives. Doctors are vital to saving lives, but midwives are better for normal birth. Each plays an important role and I would like to see both sides working harmoniously to make birth more enjoyable and safer.

I don’t think that the doctor should have to remember every patient, but taking the time to skim over the details goes a long way toward building trust. My first was born at a birth center and the whole idea sent my mom into a panic. She talked to her OB about it and he offered to talk to me to see if I wanted to use him instead (even though I was 7 1/2 months). I told him how much I appreciate what he was doing for my mom but I was extremely happy with my midwife so I respectfully declined. He was supportive of my decision and told me that if I needed a transfer, changed my mind, or wanted to have an OB with a subsequent pregnancy, he’d be happy to do so. Needless to say, 2 years later when my insurance refused to cover a midwife, I went back to him. When I came in for my first prenatal, he “knew” who I was. I’m sure he just read my chart, but it meant a lot. I still laugh about the fact that when he started doing my pap he actally said “so how’s your mom?”. Lol! We talked about her for a few minutes and he even said he was worried because she never showed up for her 6 week postartum visit (yes, she had a baby after me). I had to kindly defer that to his office staff since they illegally refused her care and had forged her name on some paperwork and she had a lawsuit against them, but that’s a whole other story. It bothered me that he didn’t know, but I’m quite sure he got all the details afterward because the problematic office staff member was fired shortly after and the lawsuit settled out of court. Anyway, he even asked how everything had gone with my first birth and we talked about how to make this one as similar as possible. It turned out very different, but anyone can see why I agreed to augment my labor so that he could be the one to deliver my son! A little forethought and compassion goes such a long way in the medical field.

BTW, I live in a city of 150,000 and he’s quite the busy man!

This submission represents something much grander than the problem of OBs not reading charts. It proves that modern obstetric practice as a whole has gotten out of hand. Giant practices, on-call and rotating physicians, doctors who only see clients long enough to catch their babies, women processed on assembly lines…. and to top it all off with a cherry, we pay a high cost with our bodies and our wallets. With all of these factors contributing to de-personalized maternity “care,” no wonder midwives are the wave of the future!

Another thought: Marsden Wagner, a former WHO physician, addresses the problem of obstetricians, surgical specialists, attending normal, every-day births. They perform complex surgery, and then rush back to the office to counsel “a healthy pregnant woman on her sex life” (to quote him). If they’re this over-extended, so much so that they forget the names of their clients–or don’t even have time to read their charts–it only makes sense to have them scale back on their tasks and do what they’re trained to do: high-risk, specialized cases.

And another thought!! (Ahem, sorry!) Am I the only one who sees a slippery slope here? If the doctor can’t know or even take the time to learn a woman’s name, how is s/he going to know all of the critical information required to oversee her birth? Charts aren’t just there to teach people names, you know.

Write your local representative and tell them why you feel we need more caregivers such as midwives in the system, and to move towards legalization where they are not recognized.
Check out our website http://www.ncdocsformidwives.org for more info about this issue in NC.