You’ve just walked into your new prenatal care provider’s office for your first visit and are wondering how you two will work together during the next months. Is she/he warm and curious about you or is she/he mostly interested in your health statistics? The threat of malpractice lawsuits makes many care providers and hospitals practice defensive medicine and rely heavily on informed consent, which can affect how your care provider acts toward and works with you.
What is Defensive Medicine?
In the US, 85% of OB-GYNs have been sued for malpractice.
Consequently, many compassionate care providers or hospitals work from a self-protective position that covers them from liability instead of from a warm relationship that provides the best healthcare (a healthy therapeutic alliance).
An unintimidated doctor will create a healthy therapeutic alliance with you by getting to know you, your lifestyle, and your personal philosophy. Unsurprisingly, these healthy therapeutic alliances tend to create better results for both you and your doctor—even in difficult situations where everything doesn’t go as planned.
In deciding on your best care, a defensive doctor tends to use your informed consent and test results instead of knowing you as a person. Data-driven care can make patients feel like the doctor is emotionally detached.
Defensive medicine doctors may order extra or unnecessary tests. Or, instead of spending more time talking to you, they use that time to write extensive notes to protect themselves should anything go wrong.
Both practices increase medical costs. And unnecessary tests could expose you to unnecessary risks.
According to Marc Siegel, MD, “It isn’t just fear of lawsuits that drives testing. There’s a philosophy of practice that encourages defensive medicine. It’s part of the culture of not wanting to miss anything and not being criticized for not covering all the bases.”
What is Informed Consent?
When your doctor tells you about the risks and advantages of a medical treatment or test—and you agree to those—you are giving your informed consent.
You are entitled to make decisions about your own health as long as the situation isn’t a life-threatening emergency, and you are mentally competent.
Knowing what you’re agreeing to is important. But studies show that most people remember very little medical information once they leave the office and remember even less a few days later.
What they remember more is how their doctor made them feel and how much trust they have in that care provider.
What You and Your Doctor Can Do
Communication is key and one first step you can take is to involve your doctor in helping you write your birth plan.
As you talk about your birth preferences, your health status can determine the range of choices you have. This is a great time to talk to your care provider about any health issues that could affect your birth plans.
If you realize that your doctor practices defensive medicine, be prepared to be succinct in your appointment:
- Bring a list with your birth preferences
- At the beginning of your appointment tell your doctor that you have a list of questions to go through
- Know how to ask your questions clearly so your doctor sees you’re making the most of your appointment time
- Jot down her/his answers to your questions
Being prepared and asking clear questions shows your doctor that you are serious about any informed consent you give. It helps them to trust you more so they can be less defensive.
And, this conversation will show if you and your care provider are on the same page. If you are, that’s reassuring to know. If you aren’t, can you change care providers?
Defensive medicine is common, but your birth plan could be key to developing a great therapeutic alliance for the day you pack your hospital bag and head to the hospital.
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This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner. These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.
Published: February 27, 2018 | By SP Turgon, Certified Labor Doula | Reviewed by: The Best Ever Baby Expert Team | Last reviewed: February, 2018