Denise makes a good point in that not all hospital policies are set by
doctors.  Policies meet legal standards, meet hospital accreditation
standards, address cost containment issues, and often are a sort of
consensus statement.   Also, when doctors do make the decision they are
often heads of their departments.   There can certainly be disagreements
from the ranks.

For the most part if a doctor disagrees with a protocol s/he can write an
overriding order for an individual patient.   Patients can request this sort
of overriding order.   Protocols are sort of a  "this is the way we do it,
so you don't have to ask, unless told otherwise, then do it that way" sort
of instruction.  As with most things, courtesy, persistence and
assertiveness go a long way.   BUT, if one wants too many variances then one
should think about a different setting for their personal and/or
professional care.   You can only fight City Hall so far if you are also
living within its confines.   That is why I choose a freestanding birthing
center with CNMs for my last pregnancy, too many battles for me personally
in a hospital setting though I choose to continue to fight them
professionally.

        Carla

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