Thursday, June 25, 2020

Why Is It Critical for a Doctor to Have Hospital-Admitting Privileges?


            In 2014 Louisiana passed a law, Act 620, that required abortion doctors to have hospital-admitting privileges. The law was challenged in federal court even though it makes perfect sense. The case – June Medical Services v. Russo – went to the U.S. Supreme Court, and a decision is expected any day. Hopefully, the Justices will see that the law is essential and constitutional.


            Damon Cudihy is an obstetrician and gynecologist (OB/GYN) and expert witness for the law as it was challenged in federal court. He stated that this bill was written by a woman, had “overwhelming bipartisan support,” and “was easily voted into law with virtually no opposition.” He was surprised when it was challenged in court. “It made perfect sense to me as a doctor. After all, every other doctor serving at outpatient surgical centers is required to have hospital-admitting privileges. Why should doctors at abortion centers be held to a lesser standard?”


            Cudihy has more than 20 years of experience as a doctor. He has completed “extensive study of the issues involved,” and he has dealt with female patients who came to emergency rooms “with complications from induced surgical abortions.” Because of his experience, he has handled serious problems that were made worse by the fact that the abortion doctor did not have hospital-admitting privileges.


In my assessment of patients, precious time was lost while attempting to contact the abortion provider or at least to obtain medical records that would have helped me to better care for this patient who presented to the emergency room….


They were first evaluated by the triage nurses, then an ER doctor, and then I would be called, since the doctor who performed the abortion did not have admitting privileges.


With these patients, I was often disappointed to learn that there was no way to contact the doctor or to obtain pertinent medical records that would have provided critical information about what procedures had occurred or what medications were given.


Further compounding the problem, these women often seemed hesitant to share many details even as they understood them.


Knowledge of preceding medical or surgical interventions is essential for establishing a diagnosis as to the nature of the complication and how to treat it.


I have no doubt that more lives could be saved, and many lifelong health complications avoided if such patients could have continuity of care from the doctor who originally performed the surgery.


            I have strong feelings about dealing with doctors who do not have hospital-admitting privileges because I had experience with one of them. Last December, after about a month of feeling pressure in my chest, I went to my primary care person who performed an electrocardiogram (ECG) to measure the electrical activity of my heart and the rhythm and strength of my heartbeat. She did not like the results of the test and referred me to a cardiologist for further testing.


            The cardiologist and his assistant had me walk on a treadmill until I felt the pressure and then did an echocardiogram. This is an ultrasound of my heart that uses sound waves to create a picture of my heart. With the echocardiogram, the doctor could see that there was a problem with a muscle in my heart. He gave me some medication and scheduled me for a heart procedure for Monday. Well, I did not make it until Monday.


            I took one of the medications before eating at a restaurant on Friday evening, and I got dizzy and passed out about 15 minutes later. The ambulance was called, and more tests were done. I was taken to the emergency room where the ER doctor determined that I should be admitted to the hospital. My family and I waited in the ER for more than an hour for my doctor to come to admit me. As it turned out, the cardiologist that did the test did not have hospital-admitting privileges and the results of the test were not available to the people in the ER. The doctor who came to admit me to the hospital was from a different clinic, and my heart procedure was performed by a team of doctors that I had not seen previously. 


I was told that I have coronary heart disease and that a stent was placed in my heart. However, I was fortunate to get the procedure done before I had a heart attack and before damage was done to my heart. I did not return to the first cardiologist for follow-up care but stayed with the doctors who did the procedure. In a life and death situation, I want a doctor with hospital-admitting privileges. In fact, my son who is an ER doctor told me to carry the information about my heart with me, so the ER doctor will have the latest information in case of emergency.

            I believe that the Louisiana law requiring abortion doctors to have hospital-admitting privileges is a good law. In case of an emergency, the woman could be taken to the hospital by ambulance and the doctor could accompany her with all the records and information.

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