Clients

So much, so much going on.

T is home!  We've been calling each other a bunch but haven't been able to meet up in person yet.  I'm so relieved to be able to turn her whole practice back over to her.  Phew.

I finished providing care to my client who had a miscarriage.  They were awesome to work with and may be my most grateful clients ever.  It was a very intense experience, I learned a whole lot, and I'm glad everything happened without complications.

I called a potential client today and told her I could not be her primary midwife.  I'd been agonizing over this decision and after talking it over with Louis and T, I know I made the right decision.  I've already spent about three hours with her for free and she wants me to figure out how much insurance will pay (a process I have to pay for) before she signs up.  I don't have the energy to take on super high maintenance clients who nit-pick about money and constantly stress about whether I'm making them happy.  Don't wanna do it right now.

I realize it's a luxury to be able to turn down work and I am really grateful I get to make the choice.

I called my billing service today and discovered that I'm outside the date range for getting reimbursement for a newborn screen through Aetna.  At the time, I had a conversation with my clients about whether they wanted to go to the hospital for the newborn screen or have me do it at home during a postpartum visit.  I let them know it would cost $111 to do at home and we could bill insurance for it with no guarantees, or they could have it covered by going to the hospital.  They chose to have it done at home to avoid the stress of a postpartum hospital visit.  Now that we're not able to get it billed, they offered to pay me "something to help" with the cost of the test but it won't likely be the full amount.  So much for informed consent and trying to make their postpartum a little more convenient.  An expensive lesson for me.

I'm tired of feeling unappreciated and taken advantage of as a midwife.  Seriously, are there any other healthcare professions where people think the fees are negotiable?  I get asked a lot, "if we decide to hire you past ___ weeks, will there be a discount in your fee?"  NO!  It's actually more work to take on somebody at the last minute.  Would you ask your OB the same question?

What I so want to ask people sometimes is, "Do you think you would receive better, more personalized care from an obstetrician or from a midwife?" What that really means is, "Do you want to be treated like a child or like an adult?"  Insurance complicates things so much but I sometimes wish more people just had the balls to go for what they really wanted.

And while I'm venting, for goodness sake, I wish people were nicer to midwives.  I've been witness to a few situations where clients treated their midwives with an attitude and I so wanted to remind them that the midwife is the person who will be wiping up their poop and giving their baby mouth to mouth (potentially putting their own health at risk) if the need to save their baby's life came about.  Midwives work hard and it's a really intense job.  Just be nice.

I think I'm gonna take a break as a primary midwife for awhile.  I'm planning to assist T a few times before the end of the year and I have a very special client due in the spring and maybe I'll just be super picky about who I work with from now on.  I have to maintain my own sanity and I can't burn out just yet.

And, my baby's still little and I have the whole rest of my life to work full time.  Sometimes being a midwife really sucks.