Over at BMJ’s Open blog, Fabio Turone explains the systemic issues behind the particularly sensational headline that, as he wrote, “a woman lost her uterus, and her newborn is in a coma because two obstetrician gynaecologists went into a fistfight in the delivery room of a university hospital in Sicily.” Turone is an AHCJ member and founder of Science Writers in Italy.
It’s really a story of two obstetricians and one malfunctioning medical system. Understand those two doctors and you understand a key dilemma in Italian health care.
Obstetrician one is a senior staff doctor, who’s nominally in charge in this situation.
Obstetrician two is a young physician who, for all intents and purposes, works at the hospital as well. He’s being “paid” with a scholarship and isn’t supposed to treat patients, though, like all his peers, he does anyway. To further complicate matters, he’d also entered into a private financial relationship with the woman – something that’s also par for the course in Italy.
In this case the woman paid the doctor privately because this was the only way for her to be sure of being looked after by the same specialist all through the pregnancy, including the delivery, in the public hospital (when a woman is looked after privately by someone working in the hospital, the colleague in charge on the day of delivery usually doesn’t interfere: it’s standard practice, and it is considered fair play).
So, it was a matter of seniority within the hospital running head-on into an outside doctor-patient relationship. Ironically, Turone said, the government had already taken measures to end such fuzzy relationships in 2007 – but then delayed their implementation until 2012.