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	<title>Comments on: It&#8217;s Big Business!</title>
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	<link>http://drchip.wordpress.com/2009/01/05/its-big-business/</link>
	<description>The director of the Sexual Medicine Center leaves penile implants behind, and launches a quest for knowledge about Artificial Intelligence, extended life, and the issues inside the health-care industry.</description>
	<lastBuildDate>Mon, 23 Feb 2009 22:52:38 +0000</lastBuildDate>
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		<title>By: retired urologist</title>
		<link>http://drchip.wordpress.com/2009/01/05/its-big-business/#comment-831</link>
		<dc:creator>retired urologist</dc:creator>
		<pubDate>Mon, 23 Feb 2009 22:52:38 +0000</pubDate>
		<guid isPermaLink="false">http://drchip.wordpress.com/?p=611#comment-831</guid>
		<description>@Jeff:

Outcomes in obstetrics are usually reflected as &quot;infant mortality rates&quot; and &quot;maternal mortality rates&quot;. Here are a couple of web sites I found with those statistics for the Los Angeles area; I&#039;m sure there are others. A call to the administration of the hospitals you are considering may result in their specific results, which you could compare to the overall rate.

http://lapublichealth.org/mch/fhop/fhop98/individ/p81.pdf
http://publichealth.lacounty.gov/mch/ReproductiveHealth/LACMQCC/lacmqcc.htm

The Medical Board of California may be able to give you information about the malpractice or disciplinary records of physicians you are considering.

That said, putting the whole picture together is much more complicated. First, I would avoid teaching hospitals unless your wife is having a complicated pregnancy involving expected protracted special care for the newborn, and even then, many private hospitals have fine neonatal intensive care teams. While Robin Hanson seems to think that people go to teaching hospitals for &quot;status&quot;, those with common problems usually go there because they are on welfare, Medicaid, or Medicare without supplemental insurance. Second, whatever hospital you choose may or may not be used by whatever doctor you choose. Third, whatever doctor you choose, you must consider the entire group with which he/she takes call, since 2/3 of every day is not during &quot;regular business hours&quot;, and unborn babies don&#039;t know that. The odds are relatively slim that any one doctor will actually be the one who handles the labor and delivery, unless it is a scheduled C-section or induction. Most groups have the pregnant woman see all the doctors prenatally so that a relationship is formed to cover this situation.

Once you know your insurance options, I think you would do well to look around for intelligent couples who have already been through the process and get their feedback on doctor groups and hospital experience. Attentive monitoring of the mother&#039;s progress during gestation is the best insurance against labor and delivery complications; previous mothers will know the level of prenatal attention they received. Hospitals (and some doctors) do a lot of marketing (one way or another), but it&#039;s difficult to fake the actual product as experienced by the consumer.

Lastly, remember that throughout most of the world, and for most of the time that modern Homo sapiens has existed, most babies were/are born without any medical intervention. The &quot;advanced&quot; US system, with all its interventional capabilities, ranks somewhere in the 20&#039;s worldwide for mortality results.</description>
		<content:encoded><![CDATA[<p>@Jeff:</p>
<p>Outcomes in obstetrics are usually reflected as &#8220;infant mortality rates&#8221; and &#8220;maternal mortality rates&#8221;. Here are a couple of web sites I found with those statistics for the Los Angeles area; I&#8217;m sure there are others. A call to the administration of the hospitals you are considering may result in their specific results, which you could compare to the overall rate.</p>
<p><a href="http://lapublichealth.org/mch/fhop/fhop98/individ/p81.pdf" rel="nofollow">http://lapublichealth.org/mch/fhop/fhop98/individ/p81.pdf</a><br />
<a href="http://publichealth.lacounty.gov/mch/ReproductiveHealth/LACMQCC/lacmqcc.htm" rel="nofollow">http://publichealth.lacounty.gov/mch/ReproductiveHealth/LACMQCC/lacmqcc.htm</a></p>
<p>The Medical Board of California may be able to give you information about the malpractice or disciplinary records of physicians you are considering.</p>
<p>That said, putting the whole picture together is much more complicated. First, I would avoid teaching hospitals unless your wife is having a complicated pregnancy involving expected protracted special care for the newborn, and even then, many private hospitals have fine neonatal intensive care teams. While Robin Hanson seems to think that people go to teaching hospitals for &#8220;status&#8221;, those with common problems usually go there because they are on welfare, Medicaid, or Medicare without supplemental insurance. Second, whatever hospital you choose may or may not be used by whatever doctor you choose. Third, whatever doctor you choose, you must consider the entire group with which he/she takes call, since 2/3 of every day is not during &#8220;regular business hours&#8221;, and unborn babies don&#8217;t know that. The odds are relatively slim that any one doctor will actually be the one who handles the labor and delivery, unless it is a scheduled C-section or induction. Most groups have the pregnant woman see all the doctors prenatally so that a relationship is formed to cover this situation.</p>
<p>Once you know your insurance options, I think you would do well to look around for intelligent couples who have already been through the process and get their feedback on doctor groups and hospital experience. Attentive monitoring of the mother&#8217;s progress during gestation is the best insurance against labor and delivery complications; previous mothers will know the level of prenatal attention they received. Hospitals (and some doctors) do a lot of marketing (one way or another), but it&#8217;s difficult to fake the actual product as experienced by the consumer.</p>
<p>Lastly, remember that throughout most of the world, and for most of the time that modern Homo sapiens has existed, most babies were/are born without any medical intervention. The &#8220;advanced&#8221; US system, with all its interventional capabilities, ranks somewhere in the 20&#8217;s worldwide for mortality results.</p>
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	<item>
		<title>By: Anonymous</title>
		<link>http://drchip.wordpress.com/2009/01/05/its-big-business/#comment-830</link>
		<dc:creator>Anonymous</dc:creator>
		<pubDate>Mon, 23 Feb 2009 14:52:58 +0000</pubDate>
		<guid isPermaLink="false">http://drchip.wordpress.com/?p=611#comment-830</guid>
		<description>Hi Dr. Chip,

I have to admit when I changed med. groups/hospitals for our coming baby I did rely upon a famous name and anecdotal internet reviews.  Where might I look for more stats?

Thanks,
Jeff</description>
		<content:encoded><![CDATA[<p>Hi Dr. Chip,</p>
<p>I have to admit when I changed med. groups/hospitals for our coming baby I did rely upon a famous name and anecdotal internet reviews.  Where might I look for more stats?</p>
<p>Thanks,<br />
Jeff</p>
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		<title>By: Stephen M (Ethesis)</title>
		<link>http://drchip.wordpress.com/2009/01/05/its-big-business/#comment-822</link>
		<dc:creator>Stephen M (Ethesis)</dc:creator>
		<pubDate>Sat, 07 Feb 2009 04:45:54 +0000</pubDate>
		<guid isPermaLink="false">http://drchip.wordpress.com/?p=611#comment-822</guid>
		<description>Interesting story, makes an interesting narrative.</description>
		<content:encoded><![CDATA[<p>Interesting story, makes an interesting narrative.</p>
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