Consumer Driven = Anxiety Driven?

What if, every time a passenger got nervous on a commercial airliner, the pilot had to land the plane?

This is often how I feel we are running the practice of obstetrics.

Most of us who work in the field know that most little aches and pains during pregnancy are just that. Fifteen years ago, when I started out as a midwife, we used to call them "the general miseries of pregnancy," we gave a pat on the shoulder, a dose of sympathy, and that was that.

Now, fifteen years later, I find that we are letting our patients' anxiety (and they are an anxious lot indeed) drive our medical decision making process.

Pt. calls doctor and says "I don't think it's anything, but I thought I should call and check it out..." Doctor says to triage midwife, "I'm sure it's nothing, but she sounded really anxious..."

I still pat my patients on the shoulder. I still tell them about the general miseries of pregnancy. But I'm also obliged to act as though their minor concerns are serious when I know that they are not.

Things that I used to triage over the phone-- like bloody show at term-- now need a full scale evaluation

I don't believe this is harmless.

Why have trained professionals with years of clinical experience if you train them not to trust their own clinical judgement.

Every time a passenger on a plane "hears a funny noise" the plane is not about to crash.

And every time a pregnant patient feels a twinge, it doesn't mean impending disaster.