Posted by My OB said WHAT?!?.
Jun
15
Posted by My OB said WHAT?!?.
“I Am Suprised You Even Know What A Condom Is…”
“I’m surprised you even know what a condom is, being pregnant at 17.” -OB to mother who inquired about the OB putting a condom over the probe used for a transvaginal ultrasound during an exam for a threatened miscarriage.
There are 29 comments to this post.
*smack*
Geesh, I’m beginning to feel some medical folks actually HATE women/girls. Why on earth would you be so unkind?
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Sarah Dorrance-Minch Reply:
June 15th, 2010 at 7:46 am (Quote)
Because she’s a teenager, and we don’t treat pregnant teens like human beings. It might give them the wrong idea, you know, like they’re actually worth respect or something. Can’t have that. (Note: I’m being sarcastic.)
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Jane Reply:
June 15th, 2010 at 8:33 am (Quote)
I wondered that too, and then it hit me. So many of the comments on this site are attributable to burnout.
Think about it: a doctor goes into a profession where he (male for the sake of clarity in writing) wants to help women have a safe birth. He begins to view birth as a minefield with hidden dangers around every corner, every process a potential area to screw things up.
His insurance company demands that when he’s in the office, he see a woman every nine minutes. That’s six patients per hour, approximately, and over the course of an eight hour day he’s seen 48 women (because although he has a lunch, there are always a few patients taht get “fit in.”
Most of these women have the same questions. Some of the women seem to want to game the system to get an extra ultrasound or an early induction. Many of the women resist what he suggests for whatever reason, or else they just don’t comply, and over time the doctor begins to feel he needs to protect these women from themselves.
In the meantime, he has patients who have to actually deliver, and for their deliveries, he has to trust the nurses at the OB ward to adequately monitor the patients and to call him in time to make the catch, knowing all along that they’re understaffed and there’s no telling which anesthesiologist is going to be handling his patient, if it comes to that.
Then he gets called in to the birth, but he has 48 patients he needs to see tomorrow and it’s three in the morning. Everyone is screaming at the mom to push but she doesn’t push as hard as he thinks she should. He’s remembering a case from two years ago where the woman pushed until she passed out and then had an amniotic fluid embolism and died, and that’s always in the back of his mind because he NEVER wants that to happen again, ever.
Then he goes in to see a pregnant teen and he thinks it’s a darned shame that kids these days yadda yadda and while he’s getting ready to do an ultrasound on her, and she’s upset that she may be miscarrying while he’s secretly thinking it would be best for her because he’s seen so many seventeen year olds delivering alone and frightened, she had the audacity to tell him how to do his job.
So he snaps at her about the condom.
It honestly sounds like burnout. Because a doctor in a state of burnout is going to begin hating his patients for increasing his workload and making his job harder. 
And it goes back to the doctor thinking he is the only one available to save every pregnant woman, who is a time bomb walking around with some problem ready to kill her and the baby.
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Laura Reply:
June 15th, 2010 at 9:15 am (Quote)
Such good thoughts, Jane! I do think it’s got to be a constant uphill battle (with feet in shackles! With insurance companies and lawyers throwing flaming bags of poo at them! With bureaucracy weighing them down!) for docs to preserve the passion that got most of them into the medical field in the first place.
I agree that a lot of what we see here would absolutely SHOCK the OBs’ ten- or twenty-years-ago selves. It doesn’t excuse it, certainly, but I know that all those pressures you mentioned just add fuel to my passion to see change WITHIN the hospital maternity system as a whole. I think a lot of so-called “solutions” to the problems within our maternity system amount to reversing the roles of OBs and birthing women, to subjugate those b@stards just like they’ve subjugated us! But a different kind of disrespect is never the solution to the problem of disrespect — even systemic disrespect. This is why it’s so disappointing to me that with all the sweeping health care changes, litigation/tort/malpractice reform was never even on the table. If we don’t work to remove the fear element on the doctor’s end, I despair for the possibility of real change. (Obviously there’s more to it than just that, but that’s a big part of the non-evidence-based medicine being practiced. When you’ve got an overpaid insurance company drone telling you they won’t cover you if you do x, y, or z because their actuarial tables from 1984 are telling them people sue if something goes wrong… that’s a darn terrible place to be.)
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Mama Wears Combat Boots Reply:
June 15th, 2010 at 11:48 am (Quote)
Great thoughts, Jane. That’s why I’m so happy that a freestanding birth center is opening in our town. It will take some of the workload from the OB’s. They tried to prevent the birth center from opening, though, so I think in our case they were worried the birth center would take business away.
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Jane Reply:
June 15th, 2010 at 1:52 pm (Quote)
At The Green Hospital back in my old city, the doctors at one practice actually managed to get the midwives’ hospital privileges taken away. The midwives who *worked in the same practice.”
Some luminary from the practice was actually quoted in the paper as saying, “Well, women wanted a midwife-attended birth more than an OB-attended birth.”
I wrote a letter to the editor saying, more or less, “I’m glad to see they take the wants of women–their patients!–into account. This was done because the doctors were losing revenue, not because there’s anything wrong with midwifery other than women prefer it.”
I’d had three births with that practice and I left it immediately when they did that. Next one was a home birth. I should thank them for it.
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Knitted in the Womb Reply:
June 15th, 2010 at 4:42 pm (Quote)
Good thoughts Jane!
I will speak up though and say that “technically speaking,” it isn’t the insurance company that demands that the OB see a patient every 9 minutes.
If the OB is in private practice, its the OB’s desire to earn a specific salary. “Salary.com” shows OB’s earning well about $250K in my area (www.salary.com).
Why is it that Dr’s think they “deserve” a salary that is about 8 times the median salary in America? (http://en.wikipedia.org/wiki/Personal_income_in_the_United_States) Because they “save people’s lives?” What about police officers who also save people’s lives, and not only that, they put their lives on the line? They make about $50K-$65K per year. Likewise for firefighters. Engineers that design our bridges and skyscrapers have people’s lives in their hands, and typically don’t earn 6 figure salaries. Or how about the mechanics who fix the brakes on our cars?
Would it be *all* that unreasonable for OB’s to back their salary down to $125-$150K by seeing women for about 15 minutes each? I mean really…that’s still a pretty hefty salary.
And before someone jumps up and says “but they’ve got malpractice insurance to pay for…” Ummm…that’s a business expense. As in, paid for BEFORE salary is considered. I’m fairly confident that the average OB is pulling down about $250K before taxes.
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Jane Reply:
June 15th, 2010 at 4:50 pm (Quote)
Firefighters aren’t paying back medical school loans.
If they’re overworking themselves, then they’ve got more burnout on their shoulders because they know they took on more than they could handle and now they’re not able to back down. You can’t tell half the pregnant women in your practice to just leave. You can’t tell the mortgage company, ‘Gee, sorry, but I’ve decided I’m having burnout and I’m going to reduce the size of my practice.’
The kind of doctor most likely to suffer burnout also wouldn’t be the one doing it solely for the money. He’d be the one who really views himself as the difference between life and death for hundreds of women and babies, and therefore reducing the size of his practice wouldn’t ever enter his mind.
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Knitted in the Womb Reply:
June 15th, 2010 at 5:48 pm (Quote)
Ummm…I’ve seen the “starter homes” that a couple of Dr’s have purchased fresh out of residency. A couple were OB’s with stay-at-home spouses, purchasing $400-$500K homes. I don’t think they were exactly struggling with college loans if they could get those mortgages.
The kind of doctor most likely to suffer burnout also wouldn’t be the one doing it solely for the money. He’d be the one who really views himself as the difference between life and death for hundreds of women and babies, and therefore reducing the size of his practice wouldn’t ever enter his mind.
Umm…yeah. When one thinks he is God…burn out is going to come when he can’t achieve that level of perfection.
I really don’t know how we can break the paradigm that doctors are entitled to such large salaries…but if we want to see improvements in the quality of our health care system, I do believe that is one change that MUST happen. Because we simply can’t get quality care if so little time is being devoted to it.
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Jane Reply:
June 15th, 2010 at 6:02 pm (Quote)
Our medical schools are producing too many specialists. That’s pretty much the problem. And then once they’re in the system, they cram in too many patients, they farm out care during labor (when it’s most needed) to nursing staff that are spread too thin and hospitals that are dictating policy based on what the attorneys say.
And yes, many doctors do have a God-complex. I won’t argue with that.
But that leads to burnout, and burned out doctors snap at miscarrying seventeen year olds when the “child” (in their eyes) points out that the doctor was making a mistake and the doctor feels angry with himself, with the system, and with the patients who keep burdening him with their problems.
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Wendy Reply:
June 16th, 2010 at 8:30 pm (Quote)
The burn-out factor is definitely there. But I also think that the OB/GYN–unfortunately–attracts its fair share of misogynists. What better way to control women–to take your anger out on them, even–than to get their feet in stirrups and dictate what goes on with their most intimate parts and processes?
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Wendy Reply:
June 16th, 2010 at 8:31 pm (Quote)
It should read: “But I also think that the OB/GYN PROFESSION . . . ”
When, oh when, will we get an “edit” option??
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Jane Reply:
June 17th, 2010 at 4:30 am (Quote)
I read a book by a medical intern who said that by the end of the internship, the conditions were so brutal that he hated his patients. He kept fighting an irrational impulse to hate these people for waking him up with stupid little issues like gun shot wounds and heart attacks when he needed his sleep after being on-shift for 16 hours.
It may be that for some specialties, especially the ones that work at night, that feeling never disperses.
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Wow, what a nasty comment! No matter what her age, that’s totally inappropriate. Run as fast as you can, hun! I guess it really doesn’t occur to him or her that birth control does have a high failure rate. I know ladies who have taken the pill religiously, no screw ups, and they’re now pregnant! Just don’t go there doc.
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Y’know, there may very well be a time and a place for an OB/GYN to have a serious conversation about birth control and its reliability with a teenager who’s pregnant. But the time or place to make snide, insinuating wisecracks to your patients is NEVER.
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Laura Reply:
June 15th, 2010 at 7:56 am (Quote)
And just so folks don’t get the wrong idea — I do happen to know several people who married and started having children in their late teens, so I (unlike this OB) am not assuming that a 17-year-old who’s pregnant is automatically just some kid who couldn’t keep her pants on.
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Two problems here: first of all, it sounds like she was she reminding him to put one one, because he forgot. That’s gross, horrible, ew.
Second, that means he felt the need to be a jerk, to get back at her. If she’d been from a culture that doesn’t use birth control, he might have said the same thing.
And SOME girls are married at 17.
I’ve met some very responsible teenagers, and very childish ‘grown ups’. Age is not always a measure of maturity or intelligence.
And, in the medical world, I believe that even if someone is a minor, if they are pregnant you treat them like an adult, at least as far as consent goes. So she had the status of adult here, and should have been treated like one.
OP, you were there to take care of your health and your baby, which is a very responsible, mature thing to do, and he should have treated you like a mature, responsible adult. He had no right or cause to talk to you in any way but professional, and if you could report him, you should.
What a creep.
PS With perfect use the condom has a 2% failure rate. I know someone who used 2 condoms because they REALLY weren’t ready for another baby. The baby is now nearly 12. 
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Nicole Reply:
June 15th, 2010 at 9:04 am (Quote)
Heck, I even know someone who got pregnant with a condom, birth control pill and spermicide. So nothing (other than abstinence, of course) is foolproof.
To the OP, Sheva is right you were doing a very mature thin by advocating for yourself. There are times, even when I was 30 that I wish I had spoken up for myself to a doctor. Good for you. I am sorry he responded in such a negative way.
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Knitted in the Womb Reply:
June 15th, 2010 at 4:55 pm (Quote)
Two problems here: first of all, it sounds like she was she reminding him to put one one, because he forgot. That’s gross, horrible, ew.
Hmmm…I didn’t read it that way. I read it that the Dr. was putting a condom on it, and she wondered why it needed a condom. Not like they put a condom on the speculum…its just that they use a sterilized one each time (or they use disposable ones), and I think the typical patient would likewise expect that the wand just gets sterilized between patients.
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partlysbabe had this to say,
Jun 15, 2010 @ 8:31 am (Quote)
I was 17 when I was pregnant with my first child, and I would have found this offensive too, I think that the OB should keep their opinions to themselves, its NOT their jobs to judge the ladies they serve, its their job to well…. sorry what IS your Job now?? babies mostly delivery themselves, Oh thats right its your job to make that process harder!!!
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Because she’s a teenager, and we don’t treat pregnant teens like human beings. It might give them the wrong idea, you know, like they’re actually worth respect or something. Can’t have that. (Note: I’m being sarcastic.)
Definatly.
I feel sorry for this poor girl. What a thing to say to a scared girl who might be losing her baby? (and I don’t care if the mother is 17 or 47… I have met very few that didn’t love that little bundle of cells from the time the pink lines showed up. Heck, my cousin at 17 the day her lines showed up announced she was going to quit buying make up because “Kaylie needs a crib more than I need lip gloss.” Oh, and “Kaylie” turned out to be a Joel.)
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This is mine. The same Dr also made the comment above this one on the main page (“you need to exercise . . . “). In my defence, I was a little overweight but I hardly think it’s appropriate to discuss it while I’m having a threatened micarrage. She was very critical and nasty through the whole process , certainly because I was a teenager. And thankfully, my pregnancy didn’t miscarry and my daughter is nearly 3 years old now. 
P.S. Dr was actually a she
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“I was also wondering about a code of ethics, because even though I’m seventeen, I also know what that is. Have you got one around? Because I’m relatively sure it says something about not making value judgments or disparaging remarks to vulnerable patients.”
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