pitocin to induce placenta delivery?

I'm actually a nurse-midwife not a doctor.

I think if you tell your provider (whatever degree) your preferences
and needs, it is up to them to meet them or tell you honestly and
politely that they can't meet them. In the case of information, my
sense is that most will be willing to discuss if you tell them that's
what you want. If they don't respond well to this, then you probably
have to find someone else to take care of you.

I find the ins and outs of clinical decision making very interesting.
The thing that makes it challenging is the fact that there are very
rarely situations where there is just one obvious right thing to do.
Usually, there is a range of options each of which has its pros and
cons and there is almost always a great deal of uncertainty about the
choices. A lot of it comes down to judgement, preference, and instinct.
I find it interesting and challenging and I tend to enjoy patients who
also find it interesting and challenging. However, many patients are
not comfortable with too much information or especially with any
admission that there are uncertainties and judgement calls in the
process - they want someone to tell them the One Right Answer and
implement it.

Some providers fool themselves that there really are a lot of One Right
Answers for almost every situation - a comforting delusion perhaps, but
it tends to make these folks prickly when someone questions their One
Right Answer.

In my last job, my group consisted of three high-risk OB doctors and
myself. All of us had different personalities and approaches to
patients. I tended to do a lot of listening to folks and explaining
things, but tried to avoid technical jargon unless the patient was
interested in it. One of the others tended to shower patients with a
lot of warmth and affection, but shared almost no information at all.
Another spent most of her time with patients "showing off" -
demonstrating her experience and knowledge. I know that sounds
obnoxious, but actually a lot of patients seemed to find it reassuring;
"My doctor is so smart, I can't understand half of what she says!"

The point is, we're all human. The vast majority of providers are
technically competent. Beyond that, you're mostly looking for someone
with a set of quirks and idiosyncracies that you happen to like.

Pologirl wrote:

After several followup phonecalls with the surgeon, including a long
one
on Labor Day, we finally managed to communicate. The surgeon (poor
thing) did resort to saying "you just have to trust me", but in the end
was
able to answer all my questions fully. I think we both saw the problem
was that we had too little technical vocabulary in common, which made
communication slow and difficult. I found it helped to give a lot of
"this
is where I'm coming from", and "according to such and such" background
information. That showed the surgeon some holes in my information,
holes which I had not seen for myself. Filling those holes helped me
to
understand why the surgeon could not answer some of my questions,
and at the same time enabled me to answer those questions myself.

It is extremely difficult for many scientists/physicians to explain
something in layman's terms. I think they *should* be able to, but it
is not an easy thing to do. That doesn't necessarily mean they are not
competent at what they do, just that they are poor communicators. Now,
I think being a good communicator is also what makes someone a good
doctor, because that's an important element to me as patient, but I
know there are very competent docs out there who are technically very
good, but have no clue how to interact with their patients.

FWIW - as a scientist, I'm a good communicator ;-) but that's because a
significant part of my work involves communicating with health care
providers, scientists, and the lay public. It's taken a number of years
and a commitment to it to get there, though.

alath wrote:

I find the ins and outs of clinical decision making very interesting.
The thing that makes it challenging is the fact that there are very
rarely situations where there is just one obvious right thing to do.
Usually, there is a range of options each of which has its pros and
cons and there is almost always a great deal of uncertainty about the
choices. A lot of it comes down to judgement, preference, and instinct.
I find it interesting and challenging and I tend to enjoy patients who
also find it interesting and challenging. However, many patients are
not comfortable with too much information or especially with any
admission that there are uncertainties and judgement calls in the
process - they want someone to tell them the One Right Answer and
implement it.

Yep. If you want to deal with reality, you have to
face up to the notion that there is no perfect choice and
every choice has risks. People have become so risk-averse
with birth that many are not willing to entertain the notion
that they might be choosing something that has some risks,
no matter how small, and get very uncomfortable when anyone
comes close to puncturing that bubble. And that's before
you get to the issue of all patients and all caregivers
being fallible.

Best wishes,
Ericka

And it would be a real drag to have all your patients be like us;
explaining
things in detail takes a lot of time and is hard mental work too. On
the
other hand, perhaps many of us already know so much that you would be
able to skip most of the routine discussion your "normal" patients
require.

on the other hand if all patients were like us, then there might be less
medical accidents, take accidental drug overdose, which does happen, if I
know what's gone in me, as long as I'm concious, if a 2nd person comes along
and says "here's something for your pain" when I've already had something,
if I ask and find out what, realise it's the same, I can flag it up. In the
end, it amounts to self protection.

Cheers

Anne