Thursday, April 17, 2008

Letter to OBitch

So after months of procrastinating I finally decided, okay, the office started calling with the 'demand for payment' calls so I was bullied into finally writing "the letter". It wasn't as hard as I thought it would be, probably because I had written it in my head so many times. Albeit the version in my head had much more colorful language and name calling but I decided I wanted the message to be heard more than I wanted to vent ALL of my feelings. So here it is, I am mailing it today, the version they will get has the doctors names in it, but because I was feeling generous I have left them out in the one that's going global. I am also writing a separate note to my old OB, who is still a member of that practice and who I still love and wish she hadn't retired from OB stuff. I know I will not be her patient again, even as a straight "gyn", which makes me sad because she truly was and is a great doctor and I doubt I will ever have a relationship with a doctor like I did with her. Another loss. I wanted her to know that my letter is not a reflection on her or the care I received from her and that I still respect her and her skills both as a doctor and a woman. So, without further it is:

April 15, 2008

To whom it may concern:

I am writing this letter to discuss my absolute outrage over being billed by your office for a “routine obstetrical delivery”, full price, after the 23 week stillborn delivery of my son. You cannot begin to imagine the shock and disbelief I felt upon opening that bill. The treatment I have received by this office in the aftermath of this devastating experience has been appalling.

My own doctor, in the hour after my son was delivered referred to the delivery as “half a VBAC”, she then repeatedly referred to my son as a “23 weeker”, the insensitivity of those remarks cannot be explained or understood by anyone who has not had to endure the agony of birthing their dead child. She also, upon entering the exam room at your office , where I was sitting a mere 2 weeks after delivering my dead son, waiting to begin a multiple loss work-up, opened the door and asked me “Why are you here again?”. Then she looked at my chart and remembered “why” she had scheduled me for the appointment. The final insult came when she had a nurse, not herself, call me to go over the autopsy results of my son. The nurse, who did try to be sympathetic, did not speak English well and kept saying there are no answers in the report. I asked several questions to which she responded, “You have to ask your doctor.” over and over. I asked her why my doctor hadn’t called me and she just said, “She told me to”. Beyond the utter frustration I felt, the information was incomplete and inaccurate. When I finally did see the autopsy report and had another doctor explain it to me, the probable cause of my son’s death was listed in the report. Information my doctor should have seen and should have been given to me personally, when I was in the office. Not in a phone call by a nurse who had no idea what she was talking about and who could not answer any of my questions. Every other mother I have met since the stillbirth, who has suffered this same loss, had a doctor, who went over the autopsy with them, sat with them in their office and answered all of the questions they had to the best of their ability. Your office should offer the same standard of care.

After being released from the hospital and then having to return to your office for follow up appointments, I was chastised not once, but TWICE, by women at your appointment desk, for missing appointments while I was in the hospital delivering my dead son. Obviously they had no idea what had happened and were quite apologetic when I explained why I had missed the appointments but it was an indignity I should not have had to suffer on top of everything else I was dealing with at the time. I had the same experience the prior year when I had a miscarriage and had to be hospitalized after my uterus was ruptured during the D &C and I missed an appointment at your office because of it. It is clear to me that your office does not have any type of system in place to communicate with the appointment desk when a patient has been hospitalized or worse has suffered a loss. In this case I would suggest that your appointment desk staff be trained and admonished NOT to question, or worse criticize, someone who has missed an appointment, for it is quite likely there is a reason for the absence and the patient is not the one who should have to apologize or explain.

I have been a patient at this office for 11 years. For the first 9 years I received exemplary care by a fantastic doctor. I felt respected and well managed as a patient. She called me at home several times over the years when crisis occurred, to check on me and remind me that she was available if I needed her. In the last two years, except for when she has come in to rescue me in times of trouble, I have felt abandoned and discarded by my doctor and the practice. Anytime I asked my doctor for help or guidance, her pat response was, “I can give you a referral to another doctor.” And in the aftermath of the stillbirth, one, only one, nurse offered me her condolences. No one else. Even the hospital where I delivered him sent me two sympathy cards, signed by every single person who cared for me and my family while we were there. Your office should consider treating mothers of stillborns with the same respect and compassion.

The final insult in this long nightmare is the “routine obstetrical delivery” label and charges on the bill received from your office. I can assure you, there is nothing “routine” about delivering a stillborn child. And it is not routine to deliver at 23 weeks. It is also not a full term pregnancy and I did not receive 9 months of prenatal care, nor will I pay for it. Certainly your office is capable of classifying a stillbirth on a bill as a stillbirth. It is a great insult to a mother of a stillborn to be classified as “routine” and have our experience and grief dismissed in such a way.

I expect my bill to be adjusted to reflect the service I actually did receive. I also hope that in the future, your office will reconsider the way in which mothers of stillborns are treated. The hospital put a sticker on the door to our room that alerted everyone on staff who entered that we were birthing a stillborn. It reduced our exposure to insensitive comments and congratulations. Your office could do the same thing to our charts, our online profile, and to the exam rooms for follow up appointments. That simple act can make the difference for a mother who is looking for and needs support and compassion. The words “I am so sorry for your loss” may seem inconsequential but they are much better to hear than nothing at all, or worse, “Why are you here?”.

To say that I am disappointed in your offices lack of professionalism and human kindness in dealing with the stillbirth of my son would be an understatement. I hope this letter is read with an understanding of the intention with which it was written, that no other mother of a stillborn is treated how I was by your office. You can and should do better.


So that's it. I have no idea how it will be received by them. Given that I have already requested for my new doctor's office to get my file from the OBitch, I won't be surprised if they ignore my letter and just refer the whole bill out to know, because I am just another "routine obstetrical delivery". Fuckers.
Please go and visit my dear friend C. over at My Resurfacing, I know she said she doesn't want the sympathy but I just can't stop thinking about her and yelling at the universe for fooling with her heart like this. It's just not fair, it's just not right and it SUCKS so much that I can't even put the right words down to say how much it sucks. I am thinking of you and hoping you'll be back soon. I miss you already.


Sarah said...

Oh, yes! Yes, yes, yes! I so wish I had the guts to write a letter like this after our delivery. My insurance actually initially denied the entire $7000 bill because it was not a live birth and said they don't cover it. It has been 9 months and we are just now down in the $200 range. I wish I had the nerve to talk to them like you did in your letter - instead I'm timid, embarassed, ashamed, uncomfortable, and weepy. You go!

Angelisa said...

Wow. You are amazing!!! This is such an incredibly brave and well-composed (jesus,I wouldn't be able to hold my anger in an "appropriate" way as you did) letter. I hope you are giving yourself a big big hug (if not, here's one from me) for speaking up and doing so in such an eloquent way. I hope this makes them take a long, hard, look at the way they not only treated you, but treat other women in the future...who knows if that'll happen or not, but the important thing is that you raised your voice, told your truth, and shared it with us all. You've got so much guts, grrl! Thank you for sharing this.

Tash said...

YESSSSSSS! This letter rocks, hard. Good for you. Other than the front desk really fucking up, my office was pretty good (and given that they were in the middle of a split and move, I'll give them a bit of leeway). That's terrible, and they need to learn these things. The receptionist at my old office in VA practically wept when I called there to tell them I was miscarrying, and actually remembered my name the next time I called and asked how I was. The receptionist! Seriously, how hard is it to find people with two cells of compassion to rub together?

Good for you, go grab a cocktail and pat yourself on the back. You rock. (And I sent C an email, even though she said not to. Couldn't not do it, ya know?)

Becky said...

I'm completely horrified by your doctor's office. The letter is spot on and I admire your balls.

CLC said...

I heart you big time. What a fantastic letter. It was so eloquent- it fully conveys your outrage yet it is professional and not juvenile calling them expletives (thinking of the nasty note I wrote..). I hope you are proud of yourself. I hope this opens their eyes and that some women in the future may benefit from this. Benefit is the wrong word, but you know what I mean.

Do you have C's email? I would like to send her one, but I can't find it on her website. I don't want to overstep my bounds either. But if you don't want to post it you can email it to me at cloftus73 at gmail dot com

STE said...

K, you ROCK!! I wish I had the balls to write such a letter. It sounds like you went through hell twice. Three times. What a nightmare. I applaud you!

And thank you for the reminder about C. I've been thinking about her, but have delayed, in trying to find the right thing to say. I'm going over there now.

MrsTSalazar said...

The letter is phenomenal! I wish I could have sent a similar letter after my miscarriage. Offices can be so insensitive.

I cant wait to hear if you get a respnse!

Lisa b said...

Good for you. They should be ashamed of how you were treated.
I am so sorry.

Julia said...

The letter rocks. And so do you.
I am thinking maybe the state medical board would be interested in reading it as well. In fact, I think they would be seriously enlightened.

Thinking about C too. Wasn't sure whether I should email her...

Brooke said...

Kudos to you for writing such an eloquent letter. I know mine would have included more words starting with the letter 'f'.

I have a letter of my own to write, to the ultrasound tech (and her superiors) who said my baby, with his heart,kidney and brain defect was completely normal at 20 weeks.

Ive been putting it off for 2 months. Maybe having seen you do yours..I can start mine...

Well done.

a- said...

Good for you K! It's amazingly self-restrained for you though!

giggleblue said...

this is a very healing stop that you took. i'm happy that you went forth and wrote the letter you intended to write.

be blessed

G said...

You kick ass, sista! Keep us updated on their response. I think I am going to motivate myself to write something to my doc soon.


Christine (Lucy's Mom) said...

i am glad you wrote this letter. the treatment you received is not only appalling but it s is reprehensible. I am assuming your OBitch works in a private practice, but you may also want to send a CC of your letter to ACOG, your hospital that you delivered at, and your State Medical board. Hospitals are required to investigate all letters they receive and i would assume that the same is true of the med boards and ACOG.

send you lots of hugs. OH and i wouldn't pay jack. i'd actually contact a lawyer about emotional harm inflicted and i am not one to pursue legal counsel.

c. said...

Fabulous letter, K. You definitely deserve to put in a F word here or there. Hope you get a response; that is, at the very least, what you are owed: A proper, considerate, apologetic response.

Antigone said...

Buttholes. I'm glad you wrote the letter. I've been shocked by the lack of compassionate care all around.

Coggy said...

You go girl. I think your letter is awesome, I can't believe what they put you through. I really hope they have to grovel to you. Assh*les

Ange said...

What a great letter.  And the fact so eloquent and not a big f bomb fest gives you a thousand more points against them.  I really hope they acknowledge this and make huge improvements.  You go you awesome thing.

iheartchocolate said...

Wow, this letter is amazing. I would report them to every possible place you can. Review them online, warning other women to steer clear. I am SO SO sorry, you are going through all of this.

Big hugs