Tag: Math

http://gatehousenews.com/failuretodeliver/explore-the-database/#midwives

A nationwide news conglomerate (Gatehouse Media) wrote several articles surrounding midwives attending out-of-hospital births. This series of articles stemmed from several complicated deliveries and newborn deaths in Florida. Ironically, Florida is one of the most regulated states with regards to midwifery licenses. In their research, the group rounded up all the midwives in the United States into one convenient database. (Thanks!) The database allows one to search for midwives by state or look at birth centers. Sadly, much of its birth center “data” is incorrect or incomplete, so I am unsure if it really gives the picture the media group was going for. However, the individual data for midwives seems to be accurate. In fact, its so accurate for Louisiana that its astounding. If we tweeze out the Licensed Midwives from the Certified Nurse Midwives, then separate the inactive licenses, from the revoked, suspended, and active licenses, we find shocking statistics, which I conveniently made into a piktochart/infographic. 

https://create.piktochart.com/infographic/saved/34853999#

The take home message is that 32% of midwives have had their licenses acted upon in Louisiana. Sound incredible? Yes, yes it is. Let me break down my findings:

20 active licenses. Out of those three have been acted upon……….. 3/20

26 inactive licenses. Out of those two have been acted upon……… 2/26

2 suspended licenses and one revoked license……………………………. 3 

If we assume that the three midwives who cannot practice because of suspensions and a revocation would still be in business as well as the two who have inactive licenses, we can add the total of active licensees to 25. If we total all the actions taken against licenses compared to the active ones, we have 8/32 or 32% of licenses that have been acted upon in some capacity by the LSBME. Midwives have been licensed in Louisiana since 1984 when the Midwives Practitioners Act was passed.

https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.78.9.1161  

The fact that Louisiana disciplines midwives more than doctors is insane and reeks of antitrust, restraint of trade, and a monopoly over the maternity care in Louisiana.  There is no denying that this Board, the Louisiana State Board of Medical Examiners, is not biased and inhibiting midwives from working in Louisiana. The biased, corrupt, unfair and unjust policing of the LSBME is driving midwives away from Louisiana and in doing so limiting choices of consumers and driving costs of maternity care in that state through the roof as out-of-hospital midwives cost around a third of doctors. No other licensed profession has more inactive licenses than active ones. One might imagine that maybe less licenses are because midwifery and out-of-hospital birth is going out of fashion? No, no it isn’t. In fact, out-of hospital birth is on the rise. Never mind its the standard in the rest of the world.  https://www.reuters.com/article/us-health-homebirths/out-of-hospital-births-on-the-rise-in-u-s-idUSKCN0WU1G1

According to the 2016 census from the Federation of State Medical Boards, there are 16, 894 active physician licenses in Louisiana.

Click to access 2016census.pdf

According to an article in NOLA.com, Dr. Cecelia Mouton, the most recent reigning Executive Director of the LSBME, between 30-50 doctors have their licenses acted upon each year. 

https://www.nola.com/politics/index.ssf/2015/06/louisiana_medical_examiners_le.html    

If we assume that the number of doctors has remained stable since 1984 (for comparison sakes with when midwifery licensure began in Louisiana,) between 30-50 doctors a year have had their licenses acted on. If we do the maths: 30-50 x 34 years=1,020-1,700 potential licenses acted upon, depending on how discipline-y the LSBME felt that year or maybe if they needed new fixtures or maybe raises? Since Cecelia Mouton still is on salary at the LSBME making $229,445 a year. 

https://wwwcfprd.doa.louisiana.gov/boardsandcommissions/viewEmployees.cfm?board=20

Back to my math problems. So, if between 6-10% of doctors have had their licenses acted upon while 32% of midwives….Houston I think we have a problem. For simplicity sake, I took the average (8%) for my piktochart. 

And we will look at why the Board might be biased in another post–one reason is that they dismantled the Midwifery Advisory Board, which is crucial in fairly assessing potential discipline actions. Most other trades have such advisory boards when the overseeing board is not the same trade and won’t be able to fairly or accurately assess what is standard of care for the trade it oversees.