10 Reasons to Have an Ultrasound

Technology has made fascinating advances in medical practice and ultrasounds are no exception. However, contrary to popular belief, they are not a tool developed so that women can find out the sex of their baby. While that is a great benefit to expectant parents who “just have to know,” the true purpose of having an ultrasound is to make certain that your baby is doing well, to measure its growth and to help a healthcare provider make a decision if he or she suspects there is a problem. So when and why should you have an ultrasound? Here are 10 good reasons that can be found in The Smart Mother’s Guide to a Better Pregnancy:

  1. To determine the age of the pregnancy
  2. To document that the baby is alive
  3. To determine the position of the baby
  4. To determine “normal” anatomical organs, usually after 18 weeks
  5. To determine the position of the placenta
  6. To determine the cause of bleeding
  7. To determine whether you are having more than one baby
  8. To document that the baby is in the uterus and not a fallopian tube
  9. To measure amniotic fluid late in the pregnancy
  10. To periodically watch the baby if you have a high-risk condition

There will be temptation for pregnant moms to get “keepsake” ultrasounds done in the mall for entertainment purposes. Not only are those ultrasounds not approved by the FDA but they could potentially miss an important diagnosis if they are not read or interpreted by a physician. The conditions listed above will give you legitimate reasons for requesting an ultrasound that can be done by a professional under the supervision of a doctor.

Remember, a healthy pregnancy doesn’t just happen. It takes a smart mom who knows what to do.

Politicians: Please Don’t Bully Our Patients for Your Personal Agendas

I normally refrain from discussing the subject of abortions. In my humble opinion, it’s a private matter between a woman, her physician and her God. Have I ever performed a termination of pregnancy? No, I have not. But would I judge a woman who had one? No I would not. And let me tell everyone a quiet little secret. When a baby is supposed to be born, Fate steps in and handles the situation. I recall an acquaintance that was scheduled to have a termination. She developed pneumonia before the procedure, it was cancelled and she went on to deliver a healthy set of twins who are in middle school thriving. So you can imagine the shock I experienced when a friend sent me an article from Time Magazine, entitled The Next Abortion Battleground: Fetal Heart Beats, by Adam Cohen.  It appears that certain politicians are proposing a law that would force a pregnant woman to have an ultrasound and listen to the fetal heart beats before she terminates a pregnancy. I would hope that our political candidates would make better use of time than to attempt to practice medicine without a license.

I’m not going to discuss the issue of Roe vs. Wade or whether the fetus has rights or if those rights take priority over the rights of its mother.  I will yield to the American Civil Liberties Union and other advocacy groups regarding those issues. However, I cannot and will not allow politicians to tell me what I should or should not do in my own examination room.  Nor should they bully my patients by dictating policy and procedures. Perhaps we need to review the definition of coercion.  According to the Legal Dictionary, coercion means: The intimidation of a victim to compel the individual to do some act against his or her will by the use of psychological pressure, physical force, or threats. Psychological pressure. Has it come down to that?

Auscultation or listening to a fetal heart beat is a clinical examination, not a political tool. Please keep your political agendas out of my exam room.

The Death of Quality Healthcare

death-of-healthcare-203x300Quality healthcare is dead.  And it was murdered by penny-pinching administrators.

An ultrasound report came across my desk the other day that made me scratch my head. On the first page, the fetus was listed as head down and on the second page it was listed as breech (feet first).  Well, what was it?  The patient was almost ready to have her baby and I needed accurate information in order to make a clinical decision.   It wasn’t the first time I had received a conflicting report of that nature and I was becoming highly annoyed.

A few days later I received two PAP reports printed in large font that included an apology for the “discrepancy” of the original reports.  A technician had originally read them as “normal”, but after they were re-read by a physician, they were in fact, abnormal.  I had the unpleasant duty of reporting to my patients that they were now at risk for developing cancer.

In an effort to “cut costs”, professional standards are cast to the wind.  The radiology department in question reverted to a voice-recognition system, eliminating transcriptionist jobs.  Because the computer can’t recognize certain words the ultrasound reports are often riddled with mistakes.   The problem is further compounded by a revolving door of radiologists who are hired as temps and read the reports remotely (outside of the hospital).  As a result of an absence of physician leadership, the radiology technicians have inadvertently “taken over.”

Yes, you can nickel-and-dime health care services, but you will also get what you pay for.    Voice-recognition software can never replace qualified human beings and neither can improperly trained technicians replace pathologists.  Physicians love to scream about tort reform, however how about putting some of these hospitals in check?  I wish my colleagues would get their complacent heads out of the sand and DO SOMETHING to promote patient safety.

 I’m tired of fighting this battle alone.