Most OB-GYN Guidelines are Based on Opinion and Weak Information!

A frightening study found that less than one-third of the recommendations from the American College of Obstetricians and Gynecologists ("ACOG")--the United States' leading group of OB-GYNs--are based on what is called "gold-standard" scientific experiments! In fact, most of the guidelines are based on expert opinion, which will certainly be informative but is also subject to personal bias and does not always translate into what is actually best for patients. So it is no wonder why OB-GYNs are among one of the medical specialties that are the most likely to get sued. The rest of the information is based on weak research data and attenuated evidence; not exactly what we want to hear when we trust these physicians during childbirth.

What the study did was go through almost 720 practice recommendations from ACOG and thoroughly evaluate each of them, accessing where such guidelines came from. A measly thirty percent of the guidelines came from solid, empirical research and controlled experiences, or trials. Another thirty-eight percent came from observational studies which has limited value, is relatively weak research, and is not repeated in controlled experiences (trials) or replicated. The remaining thirty-two percent came purely from expert opinion.

To defense, other experts countered that sometimes there is just not enough information available and-while it is certainly a shame-there is nothing that they can actually do. Moreover, some of the information that is empirically supported might be disputed or disagreed with by other experts in the field. Furthermore, some says that the OB-GYN guidelines are much more favorable than some other specialties and we should not be so critical.

But I think we should. I recognize that medicine, unlike law, is constantly in flux, changing, and evolving whereas law is more stable and calculated. Yet, people have always given birth (chicken or the egg anyone?)--this is not a new phenomenon. It is highly suspect that we cannot establish more empirical and "gold-standard" evidence for more than thirty percent of the time! One may speculate like I do that, if there were more rigid, proven, and tested guidelines, the medical malpractice claims against OB-GYNs may shrink. Or at least there would be an impact on the field, and hopefully protect one additional child from a birth-injury that could have been prevented if we weren't, essentially, guessing on the guidelines more than sixty percent of the time.

What do you think? Shouldn't there be more established guidelines? I welcome your phone call on my toll-free cell at 1-866-889-6882 or you can drop me an e-mail at jfisher@mmolaw.net. You are always welcome to request my FREE book, The Seven Deadly Mistakes of Malpractice Victims, at the home page of my website at www.protectingpatientrights.com.