November 28, 2006

Is Obstetrics Worse Than Psychiatry?

Turns out that  Plan B emergency contraception does not reduce pregnancy rates.  Big surprise.  But the one difference was that those with easy access took it more often.  (News article here.)  So I stand behind my earlier question: why do oral contraceptives require a prescription, but this doesn't?

Coupled with the fact that 50% of abortions are done by women who have already had one abortion at least, and 18% are on their third or greater and you have a social policy problem on your hands.  While everyone is busy with political nonsense, we are missing an important segment of the population that is simply not taking responsibility for their behavior.  Having three or more abortions in the United States has exactly nothing to do with abortion rights or women's health issues or access to contraception.


Oh, but it will be okay, won't it?  OB/GYN will lead the charge?   Sure.  Context is everything: in the same issue of Obstetrics and Gynecology from which the above study came is an editorial by Douglas Laube, MD, President of ACOG.  He suggests that OB/GYN has lost its way: med schools are not attentive to "differences in gender biology" (seriously.)  And he suggests doing something about it:

I will create a task force to assess whether our specialty should adapt behavioral assessment techniques to evaluate candidates’ suitability as women’s health care providers.

I wonder if "suitability" will include social/political beliefs?

Well, he does quote Isaiah Berlin, who

"set in motion a vast and unparalleled revolution in humanity’s view of itself." 


"His lectures helped to destroy the traditional notions of objective truth and validity of ethics..."  

So, even if true (it's not,) is that supposed to be a good thing? 

He's also upset that America doesn't pay its elementary school teachers enough.

Oh, and he closes his editorial with a quote "by the prophet Muhammed." Outstanding.


Addendum:  Let me explain what I mean by that last sentence, again, it's context:  he's not a  Muslim.  He is (was) a Lt. Commander in the Naval Reserve.  Are you telling me that in all of literature, the only quotation he could find to express his point is that one?  Does he have a copy of the Hadith handy?   What would you say if Mubarak (Pres. of Egypt) closed a speech with a quote from Augustine's Confessions?  This is obviously a ploy, a pretense, he wants to show he transcends the childishness of politics and religion, he's about humanity.

That's where it all falls apart, that's where it stops being science and starts being dangerous.

I looked through six other articles/addresses by him; he seems to be a rigorous and thoughtful clinician and educator-- but-- and this is the but that is killing medicine and society-- he, like so many other doctors, wants to be a social policy analyst.  No, no, for the love of God, no.


The article cited does not ... (Below threshold)

December 1, 2006 5:54 PM | Posted by KRC: | Reply

The article cited does not actually imply that Plan B does not prevent pregnancy, rather it implies that most people are unable to use it properly, even with unrestricted acess (A thoruogh misunderstanding of reproductive physiology seems less likely than subjects being drunk, misinformed etc.) This should imply that its use-like OCP-should be supervised by a physician/NP; giving patients a shot at counseling, STD screening a Pap smear and all the other routine health care OBs are getting out of by selling hormones in vending machines. (Alternately, a huge dose of depot-levonorgestrel could be given to all girls at puberty until a compelling reason to become pregnant can be furnished...)

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KRC-- you are correct, I di... (Below threshold)

January 8, 2007 3:23 PM | Posted by Admin: | Reply

KRC-- you are correct, I didn't mean that the drug did not work, I was making the reverse point-- that since it works the same as OCP, and infact _is_ the same as an OCP (except dosage) why require an Rx for one and not the other? Answer: politics. Ok, fine. But why are doctors involved in politics?

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