Pregnant EM doc

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buffywannabe

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Here's my first d-bag post, sorry everyone. I'm a new attending and just got pregnant. I went to my first prenatal appt and waited 1.5 hrs before being seen... I'm told this is normal. There are certain appts I need to go to, and I'll wait if I have to, but I'm thinking of skipping the appts (I would tell them politely I'm not coming) where they look for edema, check my bp, Doppler me, ask me how I'm feeling and charge me for a visit. My mother is super mad saying I'm being irresponsible. Any thoughts? I just think I don't really need these visits...

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Here's my first d-bag post, sorry everyone. I'm a new attending and just got pregnant. I went to my first prenatal appt and waited 1.5 hrs before being seen... I'm told this is normal. There are certain appts I need to go to, and I'll wait if I have to, but I'm thinking of skipping the appts (I would tell them politely I'm not coming) where they look for edema, check my bp, Doppler me, ask me how I'm feeling and charge me for a visit. My mother is super mad saying I'm being irresponsible. Any thoughts? I just think I don't really need these visits...
Funny... You're not an ob. You cannot evaluate your pregnancy objectively. Suck it up and go. 1.5 hr wait for ob is a little extreme. Is there another group u can go to?

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Here's my first d-bag post, sorry everyone. I'm a new attending and just got pregnant. I went to my first prenatal appt and waited 1.5 hrs before being seen... I'm told this is normal. There are certain appts I need to go to, and I'll wait if I have to, but I'm thinking of skipping the appts (I would tell them politely I'm not coming) where they look for edema, check my bp, Doppler me, ask me how I'm feeling and charge me for a visit. My mother is super mad saying I'm being irresponsible. Any thoughts? I just think I don't really need these visits...

It's just a baby. What's the worst that could go wrong?
 
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Yeah, you don't have perspective. Trust me - I've never been pregnant ('cause I'm a dude), but I'm 6ft, and was down to a buck 17 (117lbs), and I didn't think anything was going on. (Now, I'm 208 - I'm alive, res ipse loquitur, and a ****ty patient, but, alive at that.)

Suck it up, be one of the legions of proletariat, and just wait your turn, and have a healthy, beautiful little peanut to fill your heart with joy. Take all the pale, boring, simplistic doc visits as the dues. Once you have that little pink thing in your hands, you won't think of anything else.
 
You should go to prenatal visits even as a doctor. It is one of the many sacrifices you will be making here on. A lot of times pregnancies go from going well to needing emergency c sections etc, you will want to be on top of this as opposed to being caught completely off guard. And congrats. Also many clinics have long wait times due to over scheduling so likely to have variation of similar waiting at another clinic. At some point you will have to decide that you are happy with what you got!
 
Unless you have issues or do a bunch of extra testing there are only like what 16 visits tops in 9 months, they probably are not all strictly necessary, talk to your OB. Also you are not charged per visit if you have insurance your OB is paid a lump sum including routine prenatal care.
 
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"The doctor who treats herself has a fool for a patient."
Sir William Osler[ish]

That said, I like the above suggestion - ask your OB! If they say it's OK to skip certain visits, then it's fine. But your default should be to let your OB be your provider.

My medical care for my family consists of determining whether or not they need to see a doctor. If they need to see a doctor, I am not the one they see.
I suppose I could do a better job of honoring that myself...
 
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Dude. Why in the world would an OB make one of their main referral sources wait 1.5 hours? Just ask your colleague at your next appointment if there is a better way to schedule so you can avoid the wait? Phrase it like "Are Thursday mornings better for you? I could come Thursday mornings?" They'll get the picture that if they don't fix the problem, at least most of the time, not only will they lose your business but they'll lose years of referrals from you.
 
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I worked out to have more spaced-out prenatals (every 6 instead of every 4 weeks) with my first pregnancy, and had q6week at-home visits with my second. This was under the understanding that I was checking my BP and FHT weekly.
Congratulations and best wishes! I hope you don't have to wait so long next time!
 
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I worked out to have more spaced-out prenatals (every 6 instead of every 4 weeks) with my first pregnancy, and had q6week at-home visits with my second. This was under the understanding that I was checking my BP and FHT weekly.
Congratulations and best wishes! I hope you don't have to wait so long next time!

Most places should show you some professional courtesy (eg letting you have the first appointment of the day or working you in the schedule so you dont have to wait 1.5 hours, especially if they know you’re a physician).

In general you are right there are a lot of nonsense prenatal appointments mostly checking BP, weight gain and fundal height, and you could probably skip a few here and there especially in the third trimester when they are weekly and you’re low risk but sometimes stuff gets picked up that needs to be dealt with ASAP.

So my recommendation is to tell your OB that you’re a doctor (if they don’t know that already) there’s nothing wrong with that our time is limited and we need to make the most of it, and I’m sure your weight time will go down.
 
I saw an academic ob/gyn physician, she is the residency director at our county hospital and incredibly busy as you can imagine, however, she worked around my schedule, and saw me during her admin time sometimes instead of her regular faculty clinic days. Maybe this is a choice for you, because 1.5 hr is too long, I'd get hangry. I didn't feel like once a month appt were all that bad, by the time it was once every 2 week appt, I was already working less and taking it easy. Pregnancy is work, no doubt about it.
 
Not sure I'd skip appointments at the end. Those always seemed like the most important ones to me. If I were going to skip any, they'd be the ones in the first 20 weeks. I mean, you can't really do much then besides take PNVs anyway. (Well, maybe a cerclage, when do they first start doing those?)
 
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Here's my first d-bag post, sorry everyone. I'm a new attending and just got pregnant. I went to my first prenatal appt and waited 1.5 hrs before being seen... I'm told this is normal. There are certain appts I need to go to, and I'll wait if I have to, but I'm thinking of skipping the appts (I would tell them politely I'm not coming) where they look for edema, check my bp, Doppler me, ask me how I'm feeling and charge me for a visit. My mother is super mad saying I'm being irresponsible. Any thoughts? I just think I don't really need these visits...

Great, another non compliant pregnant patient.

You lack perspective in managing yourself. This is true for any physician.

In the last 4 weeks has a few close calls with patients who skipped appointments.

1. Patient had a high deductible and missed several appointments thinking she was fine in her pregnancy. Of course she rolls in with SOB and has pre eclampsia with pulmonary edema. Ends up in the unit after delivery.

2. Another patient would go 6 weeks without visits. I had to have the office manager call her and tell her we were going to transfer her care unless she showed up. Finally saw her and the fundal height was borderline. US shows a severely growth restricted kid. Immediate admission to labor and delivery for induction. Thankfully things ended up fine but I always think that this was a dead kid waiting to happen.

At the end of the day, majority of pregnancies do fine and most patients who play this game actually do well but when things go wrong, it's usually bad.
 
At the clinic my wife went to, we noticed that the first/earlier appointments in the day or the first appointment in the afternoon were best because the OB/GYN was far more likely to be on schedule at those time slots.

Also, I understand how you feel. However, if God forbid something goes wrong, nobody will be understanding. This includes family members, medical and non-medical people. Also, even if everything goes well, you will be surprised at what people blame on you. Suppose your kid develops severe allergies, a bad temper problem, doesn't like sports, whatever...there will always be some crazy family member who thinks prenatal care would have prevented that. You don't need that kind of burden while pregnant, or ever for that matter.
 
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At the clinic my wife went to, we noticed that the first/earlier appointments in the day or the first appointment in the afternoon were best because the OB/GYN was far more likely to be on schedule at those time slots.
This is almost universally true for any clinic based specialty. Even moreso when the doc may have to run to the hospital for a delivery/emergent case in the middle of clinic.
 
Yeah, the problem's with the wait time -- You do need to go.

Definitely choose your appointment times strategically as noted above, and call ahead to see if they're on schedule if you're not first in the a.m. Do pull the "I'm a physician" card and if the wait is frequently long, talk to the staff.

I was kept waiting several hours once early in my first pregnancy. When I finally got in, I told them "I bill at $X00/hour, so by my calculations, you owe me several hundred for this appointment. I understand that emergencies happen -- If Dr. Z gets called into surgery, please just call me to reschedule. If you're too busy, I can move to a quieter practice." " I got a bitc#-note I'm sure, but wasn't kept waiting again. (worth it!)
 
Here's my first d-bag post, sorry everyone. I'm a new attending and just got pregnant. I went to my first prenatal appt and waited 1.5 hrs before being seen... I'm told this is normal. There are certain appts I need to go to, and I'll wait if I have to, but I'm thinking of skipping the appts (I would tell them politely I'm not coming) where they look for edema, check my bp, Doppler me, ask me how I'm feeling and charge me for a visit. My mother is super mad saying I'm being irresponsible. Any thoughts? I just think I don't really need these visits...
You start skipping those things that need to be done to check medicolegal boxes and you may find yourself fired from the practice and unable to get prenatal care outside the ED. Don't be that guy. Or in this case, that girl.
 
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