Dear Dr. Rodney:
I have question for you. I am at a larger small hospital in rural Iowa about 100 beds with 400 + deliveries a year. We have a group of three general surgeons who will do c sections and an ob in town. There is also a family doc who does c sections( he does the best job). We have a colleague who did a residency and a fellowship and was trained to do c sections. This person has not done one since residency (seven years ago) and is now requesting privileges. We want to be fair to this person but in my estimation the physician should have some amount of retraining. This person works part time ( 2 days a week) and does no operative ob or procedures not even a circ. What is reasonable for retraining and then proctoring? Thanks D. Dickman M.D. P.S. This is a very good physician in question.
REPLY (WMR):
Easiest answer would be to scrub ten sections with your current surgeons and FP surgeon(3-4 each). Then there would be a candid evaluation of limits and continued professional development. Easier said than done in a small community.
The AAFP offers an instensive OB course each year and the next one is in March. There is another course called Advanced Life support in Obstetrics(ALSO) which should be taken and passed(2 days).
We are giving one in Chattanooga July 9-10 and I could get the doctor a spot if you want. I would personally give that physician a refresher on basic surgery issues if you wanted. We do cover Cesarean basics in that course. Therer would be an evaluation.
Finally we will be giving a day long surgery lab this Fall.
With best wishes for your professional success,
Wm. MacMillan Rodney MD, FAAFP, FACEP
Clinical Professor of Family Medicine
American Board of Family Medicine Obstetrics
Medicos para la Familia
Memphis, Nashville and rural
www.psot.com
Index--Cesarean refresher plan
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