Pregnant in med school - interactions with OB

[chanjurban]

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So I don't think that anyone else has brought this up before. As a 3rd year student, I get it that it can be difficult to give adequate time to your patients, especially when you have so many, especially in a specialty like OB which is pretty darned busy and unpredictable. And I can understand you may not want to spend a lot of time with a relatively healthy patient.

But as a patient, 2 weeks from my delivery date, I'm getting a little anxious. Is it unreasonable to feel a bit aggravated about being rushed through the appointment? Especially when there are some anxieties/questions? I have yet to rotate through OB, so I'm not familiar with how different physicians approach their patients. I've been pretty willing to put up with the rushing thus far, but today I felt the bedside manner was particularly poor - although to give the doctor a little credit, she did say that they were pretty busy.

I guess I'm asking for an answer from people who have been on the student/ health care provider side of the table.

For the record, I have tried not to take up a large amount of time during my visits because I understand the time constraints that physicians face. Today's visit with her could not have lasted more than 10 minutes. And I usually arrive at appointments exactly on time or even early and am usually seen in a timely manner. Today's interaction with the doctor has left me feeling very unsettled and anxious...
Not a good feeling to have 2 weeks before giving birth as many of you may know.

Thanks in advance from some other perpectives.

 

[sindadel]

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[chanjurban]

I've gotten a couple of responses already so I apparently need to clarify some points.
1. Not my first pregnancy
2. Have had problems in the past and therefore need some expertise
(OB vs. midwife)
3. Will likely be having a c-section.
4. It's a bit late in the game to be rearranging the major players, so I don't plan on adding or removing anyone from the team at this point.

I'm really looking for some perspectives on whether or not I'm expecting too much from my OB or not - with feeling rushed at my appointments particularly. As a 3rd year student, I've gotten exposed to a variety of Surgeons, Pediatricians, Family practictioners, neurologists, psychiatrists, and IMs, so I have a fairly good idea of what I consider poor bedside manner vs. acceptable bedside manner in each of these areas. But I haven't had exposure to a variety of OBs yet - it's my last rotation and I have to postpone it to have this baby. Ironic, no? 🙄

Thanks for the public and private responses by the way. Each one has been helpful in one way or another. 👍

 

[sumstorm]

I don't know about it from the med side...and I late stage miscarried, so can't actually talk about the birth. I can say that my Ob-Gyn spent a lot of time with me. However, he was an older doctor who didn't do high risk, he LIKED spending lots of time with his patients, and he only dealt with a very limited number of pregnant patients (he wouldn't accept new pregnant patients...you needed to be with him for a year or so before your pregnancy.) He told me he like his slower, calmer practice and that he was at a place in his life where he had the home he wanted, his kids were on their own, he was financially ready to retire, but enjoyed his work. He was also open to alternative treatments, was ok with home delivery, and he expected his patients to be educated (via reading, support groups, etc.) and not to have to simplify explanations and such. He was great at answering questions, but if it was a real basic one, he would refer you to a book. His staff was just as relaxed. My understanding from other people is his patients either loved him or hated him.

 

[dragonfly99]

. Is it unreasonable to feel a bit aggravated about being rushed through the appointment? Especially when there are some anxieties/questions? I have yet to rotate through OB, so I'm not familiar with how different physicians approach their patients. I've been pretty willing to put up with the rushing thus far, but today I felt the bedside manner was particularly poor - although to give the doctor a little credit, she did say that they were pretty busy.

For the record, I have tried not to take up a large amount of time during my visits because I understand the time constraints that physicians face. Today's visit with her could not have lasted more than 10 minutes. And I usually arrive at appointments exactly on time or even early and am usually seen in a timely manner. Today's interaction with the doctor has left me feeling very unsettled and anxious...
Not a good feeling to have 2 weeks before giving birth as many of you may know.

Thanks in advance from some other perpectives.

I think you have your answer(s) right here. It sounds like the doc is very busy, probably too busy, and that the clinic tries hard to stay on time. A lot of times, the choice is between staying on schedule and doing appointments really fast, or not staying on schedule and taking the time the patient would like. All patients would like us to stay on schedule, but also to spend as much time with them as they would like. I don't know about OB clinic, but for IM those two goals are often incompatible. I think that is the basic problem. However, it IS unfortunate. I can totally understand wanting a bit more time this close to your delivery date. Now you know this doc's practice style, and perhaps would/should choose a different OB/gyn doc or practice if you have another baby.

 

[student1799]

I have 2 kids, one of whom was born a little early (36 wks), the other full-term. At the time of ny births, I went to a wonderful OBGYN practice with 4 female doctors who worked as a team. They required you to rotate among them for prenatal appointments so that you'd be familiar with them all (and vice versa), since there was no way to predict who woud be on call when you delivered.

These were all very good doctors, although I found some of them more congenial than others personality-wise. Nonetheless, the appointments were always pretty brisk (similar to the 10 min. you cited), unless there was something truly pressing going on. I think this is pretty much the norm in OB, especially in big cities.

However, if there was ever a problem or complication, they were right on top of it and gave me excellent care. If I ever called with a concern, even after hours, I got a return call very quickly. And when I went into labor 4 weeks early with my first, which was very scary for me, my doctor got to the hospital pretty quickly and stayed with me throughout labor and delivery, even though it was a Saturday night.

My overall point is that I don't think you should necessarily judge your OB by the length of her routine appointments. Most pregnancies are fairly predictable, and there isn't a lot to talk about. What matters to me is how they perform when the **** hits the fan--which is when you need them the most.

 

[Inspire Aspire]

I think the ultimately goal should be to find a OB that you are completely comfortable with. Yes with almost any physician time is a factor, but it should not be so much of a factor that it compromises patient care or satisfaction. Particularly in OB/GYN when your patients are going through various hormonal, emotional, and psychology changes all while trying to bring another life into the world happy and healthy. Physicians need to spend enough time with a patient to be able to offer complete care without spending so much time they they are ridiculously off schedule. IN turn patients understand if an appointment runs a few minutes over.

I would suggest speaking with you OB about your concerns or finding one with whom you do not have these concerns. IF nothing else find someone in the practice that you are utterly comfortable with even if its an NP. I was/am lucky enough to have an absolutely wonderful OB/GYN. I sometimes think she must have been sent down from the heavens,for she is exactly what I needed in an OB during my pregnancy. And while I've had lots of quick appointments with her (10-15 mins) and ones that have taken longer, I've never felt rushed in either case. This was a critical point for me in finding an OB/GYN and I lucked in finding her in one shot. And because of this is she happens to be running 5,10,15 minutes behind schedule I am more than okay to wait because I know that she is doing for another patient the same thing that she would be doing for me; ensuring that I have quality medical care and ensuring that I'm comfortable and knowledgeable enough to be an active participant in my care.

 

[lainey234]

I think it is unfortunate but very common in OB.

My first OB was very much the same way, always rushed, somehwat dismissive. I was not high risk, but it was my first so I was nervous. Finally, at my 7 month appt she walked in with my chart and said "Hi" (looked down to read my name) "Lainey234, how are you today?" Really???? I don't expect her to memorize the name of every patient, but she couldn't have read my name in the hall before she came in?

I switched OB's at 36 weeks and found someone I liked better. I think because they deal with so many pregnancies it becomes commonplace and some of them forget how scary it can be for a patient. It takes just a moment of their time to make a world of differnce in what the patient experiences.

I know you said you would not change the players this late in the game. If that's the case, you can try talking with her. But it's never too late to change if you are uncomfortable.