RuralDocAlan is my Twitter handle. For those of you who are old enough not to care about my Twitter handle, my name is Dr. Alan Lindemann. Rural Doc Alan seemed an appropriate way to identify myself and at the same time let readers know I practice medicine in rural North Dakota. I’ve had many people who live in small towns tell me they live in rural areas. Well, rural North Carolina is a lot less rural than rural North Dakota. The cows far outnumber people in the county where I live. The population density here is 2 people per square mile.
Rural medicine hits the news now and then as being under great stress and for all intents and purposes, disappearing. Community hospitals are closing at alarming rates. Obstetrics have all but disappeared in rural areas. The big issue in any discussion of rural health care, as opposed to metropolitan health care, is that these two kinds of medicine are very different. Those discussing rural health care are often unaware of these variations.
One of my long-time concerns has been the obscenely high maternal mortality rate in the United States. Why am I discussing this topic instead of a professor of obstetrics at a well-known medical school? Or a committee member on some board charged with getting to the bottom of this really shameful maternal death rate in the U.S.? While committees met, I was in the trenches delivering about 6000 babies with no maternal deaths, no mothers with strokes or eclampsia, and no babies with cerebral palsy. I have learned a lot over my years of delivering babies and I believe many women and their families might benefit from the information I provide.
I began medical school in 1973. Yes, 47 years ago! During my third-year student rotation at Regions Hospital in St. Paul, I was offered a residency in OB/GYN. Delivering healthy babies from healthy mothers became my vocation, my avocation, indeed you might say, my obsession.
I was fortunate to have been part of a good residency program where the subtleties of maternal and infant danger in pregnancies were part of everyday practice. So here I’d like to thank my preceptors and the nurses in the clinic and labor and delivery for sharing with me their extensive knowledge of pregnancy, labor, and delivery.
I have shared what I learned in my video course “How to Avoid Losing Your Life in Childbirth.” It probably seems unbelievable to many, but the model for pregnancy, labor, and delivery I learned in residency no longer exists except in some home births. In this course I will tell you how, from my perspective, this patient-centered model of labor and delivery has become corrupted by the profit-mongering of corporate medicine. I wrote Modern Medicine: What You’re Dying to Know over 25 years ago to show how the physician-patient relationship was being destroyed by the profit motive of big business medicine. In “How to Avoid Losing Your Life in Childbirth” I show how the corporate takeover of medicine by profiteering has radically changed pregnancy, labor, and delivery for patients today.
I went into OB/GYN before big business took over medical care and arranged health care services to maximize profit. I have observed how the practice of obstetrics has deteriorated under this system. With health care under the thumb of big business profit-mongering, the committee call for “fixing” the problems with the U.S. maternal and infant death rate is about as effective as arranging napkins on the Titanic. It’s the old top-down approach as opposed to the bottom-up perspective. Real, meaningful reform will come only when physicians take back their control of patient care so they may practice in the best interests of their patients.