My business / practice focus is now pregnancy and childbirth management.
Over 90% of patients see me because they are pregnant and want me to be their obstetrician.
Women phone my office to make appointments to see me about gynaecology problems. My secretary will say is it not appropriate to see me because of my pregnancy care practice bias and suggest a gynaecologist colleague who has a special interest in the gynaecology problem they have. This gynaecologist doctor does not do obstetrics. This is except for past patients and an occasional new patient with particular gynaecology problems.
Having this obstetric practice bias lets me focus on an area of medical care that I consider so special and so rewarding. I can support a woman during her pregnancy and childbirth and so share in the incredible joy of the couple in having a new baby.
And then to see patients again for management of other pregnancies is truly wonderful. There is very special bond I so often build with patients. And now, because I have been an an obstetrician for many years, I have the added joy of helping deliver the ‘babies of babies’ (now adults) I helped deliver. The photo adjacent shows a wonderful patient who I helped deliver with her husband and their daughter who I helped deliver. I have helped delivery this tremendous couple’s three other daughters. ‘Second gen’ patients are so special!
As far as I am concerned, there is no more rewarding field of medicine and surgery in which to work, than being an obstetrician.
Having had excellent training, having managed over 10,000 pregnant women over several decades and now being extremely experienced, I am very confident in my clinical skills and ability to successfully deal with pregnancy and childbirth crises should they occur. I am far more able and confident than would have been the case when I was a more junior and less experienced obstetrician. Not only does experience result in me being very good at the job, but as well in being able to enjoy the job more.
A patient and her husband / partner so often comment when there is an adverse development how calm I am. The patient and their husband / partner often comment as I am calm they do not need to be stressed. Being calm is the consequence of being confident in my ability to deal with the situation. I always endeavour to discuss the developments with the couple, as well as what I am suggesting I do to safeguard my patient and their baby’s wellbeing.
What also helps is that I am extremely careful. The outworking of this is I suspect is the reason I have had relatively few complications over the years. In various meetings it is not unusual for there to be discussion about complications and adverse outcomes which, despite having been a busy obstetrician for many years, I have never encountered. That is not to say: “it won’t happen to me”, but I am being sure that being very careful and trying to anticipate and avoid what can go wrong helps me keep my patients and their babies safe.
Being an obstetrician has also become more enjoyable because of the technology changes and the internet. Being able to ultrasound scan a baby at each antenatal visit in 2D, 3D and 4D, which is now the case, adds greater accuracy to checking baby’s well being and is more fun for me and mum than just palpating her abdomen and listening to the baby’s heartbeat. Now when a woman is in labour I can check the baby’s heart rate pattern (CTG) and so baby’s well being and her progress in labour on my computer when at the office and at home. This adds another layer of safety and confidence in management. The advent and improvement in mobile phones means that I can be contacted by the midwifery staff 24 hrs a day, no matter whether I am at home or not. Before mobile phones we had pagers and when the pager went off I had to find a public phone to contact the Birth Unit. Because of the internet I have been able to develop a very comprehensive website, which is primarily for patient information and education. This has been many, many hours of work to set the website up and to maintain it. I consider my website to be very important for my patients. It has been a very rewarding undertaking. I have also been able to embrace social media for patient information and communication. The most popular way for patients to contact me now is through Facebook messaging, something that was unheard of a few years ago. Being able to post online and on my office TV patient “proud parent” photos is another new innervation that gives patients and me so much joy.
Because of the high risk and unpredictable nature and terrible hours of the job that some of my colleagues gravitate into ‘more civilised’ and more predictable, less risky, and better hours subspecialties such as subfertility, ultrasound, urodynamics, etc. For similar reasons some, after some time, will do less obstetrics and more gynaecology or do gynaecology only. Many will continue doing both obstetrics and gynaecology.
I am different in that I have gone the other way with my medical practice and now do almost all obstetrics and little gynaecology. While I am very busy and have a hectic, unpredictable and stressful lifestyle with long, irregular work hours and interrupted sleep as the norm for me being an obstetrician is so rewarding and enjoyable. The pros far outweigh the cons.
I am enjoying my practice very much. Patients sometimes ask me whether I will still be working when they have their next baby. My answer is: “I have no plans of stopping. There is so much enjoyment in being an obstetrician. As long as I am fit and able I see no reason why I should quit”. After all, why stop doing sometime that you enjoy and are good at?
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