Cost of Healthcare and Paperwork

The cost of healthcare is skyrocketing; but how much of that cost is for paperwork and not patient care? How much is paid for administration instead of people care? I’m not even taking on the insurance racket here! When I went to a specialist with my husband, the doctor spent all but a minute or two of the 10-minute visit typing into his computer. This took time that would have been better spent explaining and listening. How can this be good care? It is not.

When I asked Anita, my midwife friend, how long she spends on paperwork compared to direct motherbaby care she showed me one third of her pinky finger for care compared to a whole hand of time for paper work! Much of this is the cost to midwives of being legal and or certified.

I thought we provided good documentation and explanation when I was in homebirth practice 20 years ago—yet we spent only a few minutes of the prenatal visit on paperwork. Paperwork during the birth took only about a half hour. Prenatally we had a few “necessities” to discuss with parents such as whether they want the baby to receive vitamin K after birth. We spent most of our time getting to know the family and their needs, and explaining and discussing how to stay healthy, as well as having great conversations about birth.

Now the list is huge and mirrors the interventions performed by doctors, most of which are unnecessary or useful only in high-risk cases. Bio-physical profiles and routine ultrasound come to mind, both of which only seem to lead to more interventions. Fear is invading the home and birth center environments because of the focus on risk that is required to meet licensing requirements. What is going on here?

Health care has become “cover your ass (CYA)” instead of real care. If we are going to have a national health care system I can assure you that we cannot afford the extra cost of CYA paperwork.

It also appears that outcomes for birth are worsening because moms are being frightened. Our job and our joy used to be to encourage them and give them confidence in themselves and in the birth process. Now I am hearing midwives say (but cannot verify) that outcomes are getting worse and women are getting trapped into interventions. If this is true, could fear be the cause? How can we get out of this dilemma?

Maybe we need to develop a new counterculture!

Jan Tritten
Midwifery Today

Suspect Diagnoses Come with Biophysical Profiling by Gloria Lemay

Comments

# Jan said:

Hey everyone. We like to put a photo when possible with our blogs but we didn't have one for this. So Donna our amazing staff person made this little graphic for this one. Thanks Donna. You are brilliant.

Monday, March 09, 2009 11:58 PM
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