Thursday, March 17, 2005

Grading the Docs

When I was in college, there was this great publication they sold at the bookstores called “Grading the Profs.” It was the unofficial evaluations of our professors, compiled and summarized in a little handbook. As I recall, it touched on the difficulty of the professor’s class, as well as his/her teaching style. It showed the number of evaluations used to make the summary and there was an overall numerical ranking.

I’m sure statisticians would find the entire venture flawed. Students’ anecdotal experience, however, was that it was a pretty reliable tool for choosing between the various instructors of large courses.

The past few years I have been daydreaming about producing a similar reference for childbirth caregivers in the Ann Arbor/Ypsilanti area. “Grading the Docs” would draw from evaluations provided anonymously by patients. There would be an “overall” category, and maybe one or two others (e.g. “Bedside manner,” “Willingness to work with patients’ wishes”), as well as THAT CAREGIVER’S c-section and VBAC rates.

I would include representative comments. I would also allow the caregiver to supply a paragraph describing his/her practice and areas of special interest.

A typical entry could look like this (though these are fabricated; also n=number of responses; numerical evaluations are on a 5 point scale with 5 being most satisfied and 0 being least):

Lucille Martin, CPM
n=9
Overall: 5
Bedside Manner: 4
Accommodating Patients’ Preferences: 5
Comments: Ms. Martin gets consistent marks for her skills and respectful patient care. Several respondents said she could be a little businesslike and remote at times, though all raved about her presence during births.
Ms Martin’s Statement: “I believe in a woman’s innate ability to give birth. My homebirth practice reflects this philosophy.”
Cesarean section rate: N/A
Transport rate: 15%
Epidural rate: 0%
Supports VBAC: yes
Supports breech delivery: no

Danielle Davis, M.D.

N=32
Overall: 3.2
Bedside Manner: 4
Accommodating patients’ preferences: 4
Comments: Dr. Davis scored higher in her component areas than overall. Comments such as “no specific complaints, but no compliments either” were common. One patient wrote “I was utterly dehumanized at my birth. The things Dr. Davis said to me were unforgivable.” This was the only comment in this vein
Dr. Martin’s Statement: N/A
Cesarean section rate: 23%
Epidural rate: 90%
Supports VBAC: yes
Supports breech delivery: no

Wouldn’t even this little bit of information be helpful to women who are basically throwing a dart at the list of caregivers?

I still haven’t figured out a few key details like how to get the surveys in mothers’ hands (I doubt many doctors’ offices will agree to distribute them) and how to publish the results without being sued for libel. And of course getting those C-section rates is durn near impossible.

3 Comments:

Blogger Dynamic Doula said...

Doulicia... I must publish this post. :) I am rekindling Birth Connections, a publication for parents and care providers.. and I think your comments and examples here are fantastic. Would you be willing to write something a little longer along this same vein that I could publish in the fall? Thank you, thank you for sharing your wisdom!

7:34 PM  
Blogger doulicia said...

Kristina,

I'd be happy to write something. Please e-mail me at a2doula@hotmail.com when you have an idea of how long a piece you want, etc.

thanks for your encouragement!

9:50 PM  
Anonymous Anonymous said...

The Center for Improving Maternity Services (CIMS) is working on the Transparency Project which will allow women to answer a survery about a care provider. This is being test run in New York City beginning this summer and is planned to be nationwide in summer of 2008. CIMS is working on this with ICAN and BirthNetwork.

9:50 AM  

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