Doctor Shopping, the Life I Chose as an OB/GYN and the Over Medicalization of the Birth Process

Written By: Written by: Dr. Jonathan Weinstein

Today a patient and her husband came in to see me determine if I was the right fit for her high-risk pregnancy. I find these situations awkward, as I am not a car salesman looking to sell you a car. Honestly, when patients come in for a consult I really do not care if they pick me as their doctor or not. I am not trying to be smug and I did not take offense when the husband commented on the waiting room being empty. I just stated the facts, ”I have fifteen patient slots a day, four exam rooms, I am not looking to get rich being a doctor so I only perform ten deliveries a month.”

My first priority is my family, I love spending time with my wife and kids. I do not have many individuals outside interests, except the New York Yankees & Giants and a twice a year vacation to a tropical location where I do absolutely nothing but read Dirk Pitt novels and sleep until at least noon with my honey. As an Obstetrician, my job is to help people achieve a common goal, bring a healthy new baby into the world the way g-d intended.

I went on to explain to the couple, “I have been practicing OB/GYN, for fourteen years, starting my career in a twelve-person group that went to four different hospitals. I could deliver as many as ten babies a day and not know one single family, but I made good money and only took call every 12 days.” Sounds like a sweet deal except for the fact I had no relationship with my patients, spent maybe five minutes talking to a return OB, maybe 30 minutes with a new patient, and 15 minutes with an established patient.

Now I have my dream job, working in an office attached to the ONLY hospital I deliver at, Baylor Medical Center Frisco, with well-educated, considerate, sometimes a little Internet happy patients (you know who you are). Many of whom I consider my friends and often my neighbors. I have a great office staff, a nurse practitioner in Tara who will be able to take care of my patients when I go on vacation.

I have rededicated myself to personally lowering the national Cesarean Section rate one vaginal delivery at a time. I know every patient in the practice, how many doctors can say that? I have fixed medical problems other physicians have missed, just by listening to my patient tell their stories. I get disgusted when I read charts on patients who had a C/S for breech presentation, preeclampsia, ‘the baby’s too big’ or the countless other b-ll sh-t reasons patients are given.

I practice medicine based on scientific facts, not whether it is getting close to dinnertime. Let me tell you a dirty little secret you will not see printed anywhere in OB literature, at least 90% of all emergency Cesarean Sections for fetal distress are caused by the ‘over-medicalization’ of the birth process.

This is what happens every day all over this country:

  • You get too much Pitocin so the baby crashes because it could not get enough oxygen due to every 1-2 minute contraction intervals
  • Your electronic fetal heart monitor was over read as showing a baby in fetal distress (despite being born screaming with great APGARS),
  • Your blood pressure was dropped by your Epidural cutting off blood flow and oxygen to your uterus and in turn your baby.

Why do you think babies born by Nurse-Midwives or at Birth Centers have only a 10% chance of ending in Cesarean Section but at a hospital around here, it can be upwards of 50%? Just some food for thought.

Jonathan Weinstein, MD, FACOG

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