VII. OB/GYN
The field of obstetrics and gynecology is a young one in comparison to other medical specialties. This is interesting, in that the main focus of this month is obstetrics, in my case, primarily deliveries and managing a pregnant patient, which is something that has been going on since the dawn of time with little to no intervention. Modern medicine has turned a natural event that is not without it's risks into a medical problem or procedure. We as physicians feel the need to 'do something', and give us some technology and a woman in labor, we will likely start mucking with things. In the US, we don't have very good infant mortality for the amount of work and intervention we do.
That fact seems to point to the wave of the future, where we are seeing that less is more in most cases of childbirth. We see more instrumented or operative deliveries (forceps or vacuum extraction) with the continuous fetal monitoring that has become standard of care. We also see women being less empowered as the norm of laying flat on your back with your feet in stirrups while someone pulls your baby out is assumed. I love that there are free thinkers out there who don't drink the Kool-aid wholeheartedly and continue to question things. We are driven to practice evidence based medicine, and many of the methods used in medicine are anecdotal...we do it because someone before us did it, and they were told to do it by someone else. Don't ask why, they won't know. I hesitate to jump fully on the EBM bandwagon. The evidence has to be strong for me to use it as gospel. Additionally, just because it is not evidence based does not mean it has been disproven yet. There are many things we know work, and we cannot put a good study together to prove. If it ain't broke don't fix it. Likewise, if something with good evidence is implemented, and it ends up yielding no better or worse results than what was generally accepted, is that good practice if we use it?
YOU ARE READING
Confessions of an Intern
Non-FictionThese are musings of mine, told as I grow through residency. I hope to share a little insight into the making of a doctor, one who still cannot believe she's been blessed with this responsibility.
