Subject: Weighing and measuring
K.Jean Cotterman wrote
>One point I have not seen mentioned in this thread is that of fear of
>malpractice issues. I think that is one very real reason there is such
>attachment to weighing and measuring in the US, because we seem to be
>such a letigious society, especially where health care is concerned.
>Some insurance rates are astronomical, depending on what classification a
>health care provider is in. Some documentation seems prudent as a CYA
>maneuver (cover your a- -, that is).
I think this is one of the cultural components Heather mentioned. When I
compare this with my situation I must confess, that this kind of questions
don't bother me. I have a small practice in which I can take time for the
mothers and children to talk with them and the communication with the
midwives and the hospital in town is very good.
Stilll, one thing I would like to share with you, that I learned in the
hospital when I was trained as a MD. One of the finest professors hated the
word "routine". Even Hb, bloodpressure, temperature and so on were not to be
taken as a "routine". With everything we measured, he asked: why did you
measure? What do you expect? What does it mean when the values are normal?
What does it contribute to your diagnosis, when the values are not normal?
Will it influence your decisions, when it is normal or abnormal? Is it the
easiest method to become this information? (and the cheapest, by the way -
he was a real dutch person!) And when we didn't answer his questions
acceptably he invariably said: than don't do it!!! Since then this questions
are influencing my practice. And in the case of the test-weighing (and some
other medical measurements) I for me came to the conclusion, I don't gain
anything (at best) and I loose something (for instance confidence of mother,
I myself will more and more dependent on values instead of what I see and
hear) (worst case)
Elien Rouw, MD, Bühl. Germany
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