Ahhhhhhh the sisterhood

If its one thing midwives and women in general are not good at, its having each other’s backs and being empathetic and supportive, which is ironic since we are trained to be compassionate, caring professionals whose job title literally means with woman. I have only met a few midwives, who have not been through some sort of legal nightmare, able to have sympathy for those of us who have records so-to-speak. I don’t understand why it is so hard to imagine that at any minute, they could be me and the laws, rules, and decisions affecting my license suspension and denial could affect them. It is a bizarre occurrence that falls somewhere between ignorance, not caring, and denial of reality.

So, since my license in Florida is going nowhere, I email some Florida midwives in peer groups and associations. Recently the midwives in Florida have had to hire lobbyists to help them fight the sunset rule changes instigated by none other than ACOG. I think to myself that perhaps I can utilize these lobbyists, again if only to put political pressure on the Department of Health or maybe they could point me in the direction of some sympathetic legislators or even attorneys they would recommend. Since I only have 21 days to file an appeal, time is of the essence, and I need to decide what I am going to do.

While the Florida midwives I know locally and have worked with have been nothing short of amazingly supportive, concerned, caring, and helpful, I feel some midwives who are more vested in the licensing system could also benefit my cause. So, I send messages to a key player in midwifery politics about my situation. This midwife is also on the administrative staff at one of the Florida midwifery schools, so she knows laws, but more importantly, she is vested in making more midwives. I get a response on 9/7 that lobbyists may not be who I want, but this midwife knows of people on the council staff.

Yeah, that doesn’t help me because you see the Council of midwifery is just a bunch of figureheads. They do cursory things but nothing substantial like have any say in licensure. I explain this to the midwife and again I request the lobbyists contact information just so I can ask them for advice. I am even willing to pay them for their time.

She replies that she will send them my contact info because they are not actually willing to take phone calls from individual midwives.

Uh that is weird, but ok.

She continues stating that the lobbyists are not familiar with licensure pathways at all, but are purely for legislative recommendations and changes.

Ummmmmm, hold up sister midwife. If these lobbyists are designed to watch laws bring pushed through the legislature, shouldn’t they know what the rules are so they can make recommendations to the changes? If that is their job then heck yeah they will understand licensure pathways. But regardless, I have completed ALL the pathways to licensure in Florida and have been denied twice. So, it doesn’t matter which pathway we look at. I have successfully completed both. I actually exceed the education requirements for Florida licensure. Oh, you want a midwife who is a CPM and was licensed in two states? That is me. Oh, you want a midwife who has two degrees in midwifery, one of which is from a Florida school? Yup also me. At this rate, I think it would be easier for me to go to the Bahamas get my medical degree and come back to Florida as an MD.

Back to my communications with my Florida sister midwife… she suggests I listen in on a legislative-focused phone call where afterwards midwives will be able to ask questions.

Uhhhhh, a conference call about legislation is not the appropriate time nor place to discuss my licensing situation.

To be fair, my sister midwife is very kind and offers to give me contact info for the Department of Health’s key figures in licensing midwives, but she misses the mark in truly helping me at all other than providing lip service.

Again, I am not reaching out to my sisterhood for names and numbers I already have. The normal mechanism for licensure is broken in my case and I need to go to plan B or C or D at this point. A week later, I reach out to her again and ask if the lobbyists have received my info. I am a little miffed with this association. Again, I am on a strict timeline.

She indicated that the lobbyists felt they couldn’t really help me and again referred me again to the DOH who started the whole denial process.

Circles, circles I tell you. I do not understand why the Florida Association of Midwives has lobbyists that will not even consult the people who pay their salaries. And for someone whose job is working at a midwifery school, I really hope this sister midwife helps her students navigate the licensing nightmare more than she has helped me. Am I surprised that I cannot get more assistance from the groups spear-heading midwifery in Florida. 

Don’t take it personally, I remind myself.  Time to go read the four agreements again. Sigh. 

Talbott Center: I don’t fit their Criteria (not surprisingly)

In the last six months, I have lost three members of my family. I wish I could go to a therapist, but I am so afraid of the LSBME finding something wrong with me that I don’t really consider going because I do not trust them not to use everything in my medical record to find me incompetent to practice midwifery. I suffer in silence. I try and sleep as best I can. It’s lonely. 

Following my (non) attorney’s advice, I call the closest treatment facility and ask for an evaluation. As expected, once I explain that I do not know why I need the evaluation, the admissions counselor asks me to send her the Board Order so that she could see if I fit criteria for admissions. I am very honest about what I think the order is asking the evaluation to determine. Keep in mind that this facility was one of five LSBME pre-approved drug and alcohol treatment centers I was given to choose from. I have bolded the admissions counselor’s responses. The Board Order that I sent to her follows.

2/7/2018 Talbott Admissions Counselor, Sorry I’ve had a death in the family so I’ve been off line for a few days. It does state the evaluation is for competency in midwifery. If this is something that can be done or is appropriately screened in a three day evaluation can you elaborate on how exactly my competency in midwifery is going to be evaluated? It seems competency is based on skills and not physical or mental criteria but I’m not certain. Thank you again for your assistance and time. JM

2/7/2018 JM, I’m so sorry for your loss.  I’m glad you were able to follow up with me, so hopefully we can point you in the right direction.  I’ve read over your Board Order, and unfortunately, this is not the type of evaluation that would fall within the scope of our assessment here at Talbott. I wanted to at least let you know that, but I am seeing if I can get any referrals for you as well.  That part may take me a little longer, but I will be back in touch if I can get you a name or two.  

Our evaluations are specifically for substance use, and the evaluation that you are recommended for is a mental competency evaluation. They basically want to see if there are any mental health or cognitive issues that would make it unsafe to resume practice.  We do this type of fitness for duty evaluation, but only as it relates to substance use disorders, so I can sort of see why you got to us. I would imagine that your eval would need to include a battery of cognitive testing and an in depth psychiatric interview at the least, but may not require you to admit to a facility to complete.   

I have a colleague that may have some suggestions for you, so as soon as I can speak with him, I may have some leads for you.  However, the LSBME will have to approve the providers that you select BEFORE you are evaluated. So make sure you get that approval first, if the provider is not on a list of approved providers you may already have from the LSBME.  If not approved, they may not accept the eval, and you would potentially have to do it again. 

I will let you know if I come up with anything.  Good luck!! Talbott Admissions Counselor

2/8/2018 Talbott Admissions Counselor, Thank you for the quick reply. I appreciate you looking into the Board Order and discussing with your colleagues what direction will be best for me to take. Also thank you for your candid opinion on what assessments I will be needing. That helps. 

Below is the list of providers the LSBME provided for me. Do you have an opinion on whether they will be in the same boat Talbott is in regarding my assessment being outside of scope? I’m not sure if you work with these facilities as well but figured I’d ask. 

Yes I realize I need to have the facility and/ or provider pre approved which is what prompted my inquiring to LSBME to begin with. Please let me know if you have any suggestions towards pursuing. Thank you again for your time. JM

2/9/2018 JM, They are all very well respected programs, you would be in good hands with any of them. While I cannot comment individually or steer you in a specific direction, I would suggest you look them up online/contact them and see what is the best fit for you.  I think if you are able to better state the nature of the assessment, which is basically reading them that first recommendation, they will be able to tell you quickly if they can help.  Our focus here is just too narrow, as we do our evaluations with the scope of whether substance use was a factor in the problems addressed by the Board. Some facilities have a wider scope of what they evaluate, with regard to the “mental/physical” aspect of the requested evaluation.  Good luck to you, Talbott Admissions Counselor