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Tuesday
May182010

So, What's the Deal with Dr. Wonderful?

If you wander the Net, mostly Facebook, especially with me, you’ve been following the saga of Dr. Robert Biter’s expulsion from San Diego’s Scripps Encinitas hospital. His obstetric privileges were removed on Friday, May 7, 2010. No one, not the hospital nor Dr. Biter has said why he was suspended. The hospital states confidentiality; Dr. Biter has been silent.

But, I have some ideas, have alluded to them, have spoken to the press about them and wanted to share them here. Rumors are a’flyin’ and it’s time they stopped. I do understand nothing will quash all the rumors except the truth, but I’m not sure when/if that’s going to come out anytime soon.

Therefore, in the meantime, you get to see/hear what the press is saying, sound bites from various acolytes and my thoughts on the whole thing.

I’ve written about Dr. Biter since June 2007 after attending the Garden Labor (where I first coined the moniker “Dr. Wonderful”). The posts continued with A Birth Unfolds in Photos and Words, one of the most viewed pieces I’ve ever done. One more, VBAC (with a whiff of pit), was also photographed and its story told. Those pieces demonstrate the wonders of natural birth in the hospital, that it can be done –with the right care provider and supportive nurses. That how the way he practices is so odd; it speaks volumes about his style. Over the last three years, women have disclosed other doctors around the country who seem to practice in much the same way. I’m thrilled to know there are more! However, there aren’t that many.

On May 14, 2010, there was a huge turn-out in front of Scripps Encinitas Hospital that included Ricki Lake and Anna Getty. There was a rally on Mother’s Day; My Best Birth gave an overview of the situation, families rotated through the week and then this big rally was the culmination of a loud outcry of his being fired. Some of the pre-rally media included this piece from CBS, the San Diego News Network, the formation of Bring Biter Back and the creation of this Petition to demand Dr. Biter’s re-instatement. Last Friday, we saw plenty of press. ABC, CBS, the Union-Tribune-SignOnSanDiego and the North County Times hung out with us for awhile, even talking to the one nurse from L&D who dared come outside to protest.

Plenty of love is given to Dr. Biter. His reputation is stellar. Or is it?

You can find a couple of so-so reviews on Yelp!, and there are dissenting views out in the community, but most hinge on the, sometimes, interminable time it can take to see him in the office. Once he is actually in front of you, you have his attention 100%. It’s the getting there that can be challenging.

Yelp! has removed other negative comments that I’ve read over the past couple of years. A common one was that he was too chummy, too huggy. His physical kindness is a hallmark in Dr. Biter’s care and is welcomed by those that adore him. I’d almost forgotten the snarky things people had to say about how he hugged them too much until a Biter Rally attendant ran into a couple of RNs that alluded to the reason behind his expulsion was because he was too “friendly” with his patients and their families. When she mentioned it on-line, the topic quickly blossomed into “I noticed his affection for his clients in the photos you took,” and “At first I was taken aback by how he touched the women in the pictures.” Upon examination, we were able to see the sexism in the equation, that if he were a female OB, it wouldn’t seem out-of-place at all. I countered that I don’t often see female OBs hugging their patients, either. But, I suggested we exchange his male OB-ness for a midwife and the “ah-ha!”s had the picture. It isn’t inappropriate for a care provider to hug a client, it’s just crazy bizarre to see an OB doing it!

In the photo spreads I’ve done, I noticed that I took the pictures because Dr. Biter was doing something so unusual, so beautifully different than every other obstetrician –and many of the midwives- I’ve worked with in my life. I went over the photos again and smiled at the love that man has for life. I look and remember every moment of the births with him. Dr. Biter is so present with his clients. No matter how tired he is, no matter how much he still has to get done, he is there with whomever is in front of him. And women/clients/families feel that kind of adoration. It is returned to him a million-fold.

I’d heard about this man, this Dr. Biter, before I went to a birth with him. I swear angels and twinkling hearts live around his name as it is said out loud. When I finally got to the birth with him, I know a part of me stood in the corner with my jaw hanging open. Who is this person? He went to medical school? He stayed with the client, he encouraged her, he breathed with her –he helped her through the rough parts until she eventually birthed her baby into her own hands.

Was this a fluke?

The next and the next and the next births were the same. Well, not the same same, but similar in their tenderness and respect. I had a mom who transferred in during a complication and Dr. Biter happened to be the Doc-in-the-Box. This mama needed a cesarean and it was clear she did, but it wasn’t a fly-down-the-hall-in-hysterics kind of cesarean. Dr. Biter was gentle with her, talked to her about what was going on, brought her a photograph of what the baby looked like inside and then we all talked about what the cesarean would entail. When the time came to go to the operating room, Dr. Biter said I phrase I have heard repeated with a couple more women –and heard he had said to other women as they were wheeled in on the gurney: “We’re not just having a cesarean, we’re going to have a birth.” I swear I swooned.

Dr. Biter welcomed me into the OR on three occasions. The anesthesiologist also said it was fine. Who refused my entry was the “circulating nurse” –the nurse responsible for the patient’s safety during the surgery. Interesting how she came to be in charge. In every other hospital for over two decades, it is the OB and the anesthesiologist who decide who goes in. Suddenly, the rules changed.

So, with all the great things this doctor seems to be doing (and has done), why would Scripps Encinitas Hospital want to push him out of their system? Wouldn’t you think other doctors would want to mimic his style so they, too, could be busy to overflowing? Wouldn’t you expect doctors to see what women are asking for and strive to fill it? Initially, it seems baffling. But, if we look at this from another angle, the point of view of the hospital and other OBs, it becomes clearer. And let’s not forget the lawyers, shall we?

From this vantage point, we see a doctor in a lone practice… a lone busy-as-all-get-out practice. The doctor does all of his own prenatals, GYN surgeries and sits with his “patients” during much of their labors. If they are VBACs, he is required to stay the entire time (per ACOG) in the hospital. How can one man possibly do all of this and be safe?

Keep looking through the angle of the medico-legal world.

Dr. Biter is known to take wide berths with, what is professionally called, Friedman’s Curve. In a nutshell, once women are in active labor (3-4 centimeters dilated), she should (red flag word right there… “should”) dilate one centimeter an hour. She should only push for two hours if this is her first baby, one hour if it is her second or subsequent. When the mass-utilization of the epidural came into effect, second stage (pushing) was extended to three hours for a first time mom and two hours for a second (plus) mom.

In the one week period during the protests, I heard woman after woman talk about how Dr. Biter never gave up on her, never having a time limit on how long she could labor/push, how triumphant they were because they knew if they’d had a different doctor, they would have had pitocin or a cesarean. That Dr. Biter believed they could birth, even if it took time, meant the world to these women. Besides the immense joy, the financial cost was greatly minimized by the births they had. The physical cost was infinitely less than a cesarean would have cost. The time healing, the time away from the family… even the time spent processing a cesarean… is miniscule compared to a surgical delivery.

But, doctors who are ingrained in the Friedman’s Curve (even though other docs have insisted it isn’t accurate) –and those that believe the Curve should be even faster with pitocin- probably see what Dr. Biter does as renegade. If he steps out of bounds with something as basic as the Friedman’s Curve, what else is he rocking the boat with?

Dr. Biter is meticulous with monitoring. Intermittent monitoring (although, with my VBAC clients, they have had continuous monitoring, as per ACOG protocols), either being listened to with a doppler or getting a strip every hour or so, has been shown, over and over again, to be just as effective as continuous monitoring and continuous monitoring restrains a woman much more than doing it intermittently. So, if the woman is being listened to periodically, that means she probably isn’t in the bed; she’s “wandering around” – a phrase I have heard many nurses use over the years. It is much easier to keep track of a woman in bed on monitors that worry about her “wandering around” the hospital (or even just her room). If mom isn’t in bed and wandering around, that means she most likely doesn’t have an IV pole being dragged behind her. She, most likely, has a saline lock, but not necessarily. (Are you counting the red flags most OBs would be seeing about now?)

By bucking convention, other doctors must be spinning in their office chairs and their hands on their heads screaming, “Horrors!” You see, to them, these things are risky (at best) and dangerous (at worst).

Cutting out all the crap, Dr. Biter surely looks like a lawsuit waiting to happen to them. I can pretty much bet they are scared witless that they will be sued should something untoward occur and they don’t have the “proof” that “everything that could have been done was done.”

Defensive medicine. At its worst.

After the NIH VBAC Conference a couple of months ago, it finally sunk in that many/most doctors do not make decisions based on what is best for mothers and babies, but what is best for themselves and their lawyers. To me, this is an abhorrent way to treat women and practice medicine. Sadly, it is the reality of our obstetric world today.

But, for those of us who believe decisions should be made based on a woman’s and baby’s unique set of circumstances, this defensive medicine mess needs to be tossed into the dung heap. It is time to stop cutting women because all the doctor can visualize is standing in a courtroom defending himself/herself.

Doctors are going to be sued; whether it is because they did something or because they didn’t do something. As was mentioned during the NIH Conference (and beyond), it is the mindset of luck, responsibility and fate that needs to be changed. Our court system needs to be changed. Tort reform must occur. Something else has to be done instead of cutting women out of fear of being sued.

Scripps Encinitas’ cesarean rate is 28.9%. That 28.9% sounds low is astonishing to me and the others who are now so used to numbers that high we almost yawn hearing them. But, 28.9% is twice as high as it should be! While I don’t know Dr. Biter’s specific statistics, I have heard rumors that it is 5-7%. Of course, I would love validation of that, plus know what his VBAC rate is; I wish California gave out the doc’s stats like some other states, do.

I’ve often called Dr. Biter a midwife in OB’s clothing. I can imagine this very description has been said as an epithet amongst other OBs. Obstetricians hold a special disdain for many midwives, especially homebirth midwives. That we have a great working relationship with him as we doula our clients or if we happen to get him during a transfer when he’s on-call is another twist in their knickers. I expect he gets a great deal of flack for even acknowledging our presence, much less interacting with us. I will be very, very sad if he is ever required to eliminate us from his professional life.

If we now pull back, far enough to cram the whole picture into a large frame, you can see how different this man is, how unconventional… even non-conforming… he is and how that, most certainly, makes other OBs (and lawyers!) squirm.

I hope that with all the love and prayer and power we are sending Dr. Biter, he is bolstering his resolve to remain one of the most progressive (in his old-fashioned way!) obstetricians in the country. We need him now more than ever.

This is why we are out there marching ever single day asking for his reinstatement. He is worth every ounce of energy.

Dr. Robert Biter with Alisa while she labors, monitored, in the garden. She VBAC'd a couple of hours later.

 

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Reader Comments (41)

I know of one doctor like him the the DFW area and I wonder when this is going to happen to him. It is mind blowing what goes on. They may as well come out and say that we can't birth and we all need to be numbed, strapped down so they can cut our babies out...they basically are anyways.

May 18, 2010 | Unregistered CommenterJanuary

This is such a great post. I actually cried reading it because I can't imagine what it must be like, for not only the women having to alter birth plans at the last minute, but also for Dr. biter and his family. He obviously is passionate about and truly loves what he does and for something like this to happen is heartbreaking, and I am sure it is embarrassing. The only good thing I can see coming of this is that hopefully the media coverage on how this Dr practices will open the eyes of other Dr's and there will be more "Dr. Biter's" out there. Hopefully this will all be put behind him and he will be able to offer his services again. The point here is, that if a woman wants to birth naturally in a hospital, she should have the right to have that choice!!! I personally wouldn't want to, but if I did, and the only person in town that could make that happen for me was suspended because someone thought he was "too friendly", I;d be protesting too.

May 18, 2010 | Unregistered CommenterNicole Yunker

Thank YOU for this, Barb. I am relatively new to your blog and so I don't know much about this doc's situation other than the alerts I see on all my mailing lists.

It is SO DEPRESSING to see it confirmed that when we see an OB and/or many hospital-based midwives, we are signing up for care dictated by fear. It was always something that was suspected, but unconfirmed. No longer.

May 18, 2010 | Unregistered CommenterVanessa

Great piece! I hope this all gets resolved soon.

May 18, 2010 | Unregistered Commentergail

WOW. I hadn't heard of him before, but I'm in love!! I hope he is successful in getting his privileges back. What a fantastic OB (believe me, that's not something I'm used to saying!!!).

May 18, 2010 | Unregistered CommenterLauren

I had a similar OB like this with one of my births, also in California. He was at Northridge Hospital and he was the ONLY OB in the hospital that accepted VBACs. He was a midwife in OB's clothing and he was nicknamed "Dr. Natural" by the nurses who obviously did not like them. They all thought he was "dangerous". So strange. When I showed up for my VBAC, I remember the nurse in charge of me was so suspicious of him that she inquired if I had been "forced" to have a VBAC and not given a choice! Wow. She had no idea that he was the ONLY OB within several counties that I could find that actually allowed VBACs! There was a political game being played at this hospital and it was sad that they brought me into it. I later learned that my cesarean orders were written up as soon as I arrived at the hospital and this nurse was behind it. She was determined to make sure that I had a cesarean and not a VBAC with this doctor. She even would call him in if I got out of bed and he would look at the strip and say i was fine and tell me to do what I wanted and the nurse would be ticked every time. She was the one that found my prolapsed cord. And I am so leery of this nurse that sometimes I wonder if she found something wrong that wasn't really there? I don't know.
He soon retired after that and I have to wonder if he was forced to retire..... so pathetically sad. This is why those who try to make changes from the inside have a difficult time... the powers that be try to make it difficult, if not impossible. I truly hope that Dr. Biter will continue to practice and be reinstated. I find it odd that this is all so secretive but I hope that soon understanding and reinstatement will come. He seems like a wonderful doctor.

May 18, 2010 | Unregistered CommenterStephanie

Barbara, I am in tears... What a beautiful portrayal of such an exceptional doctor! We would be so lucky to have him or someone like him in our area of Canada. Wow!!!

May 18, 2010 | Unregistered CommenterMichelle Maisonville

For everyone's sake, I hope you're right about him. It's scary to think about a system that would punish a doctor for being great, though.

May 18, 2010 | Unregistered Commentersara

You make a great point about the photos. While I could see how people would immediately jump to the "too friendly" conclusion, what I have noticed is that not a single one of the parents in those photos looks uncomfortable. And every one of those photos tells me that this is a doctor who CARES! And cares a great deal! My own doc ( though female) was big on the hugs and always was looking for Dad ( who she called the big guy) She visited with me in the hospital not just doing rounds but visited with me. And she wanted the baby to be a part of the visit holding her and cooing over her and making the big deal that every mom wants made over her baby. Would I REALLY want less if she had been male. NO! I might expect less but that is kind of a sad thing. I looked at those photos and I saw the miracle of birth through the doctors eyes. I was taken by the fact that it is in his eyes EVERY single time! And when I look at his photos I see a man that I want to meet! A person who I would have been honored to have at my births. C-sections can be a necessary evil. I myself had one. And to make a woman who must have one feel better about it is a wonderful thing. And to have a doctor whose personal stats are very low tells the mom that it is NECESSARY. It isn't done because Doc has a time line that has more to do with dinner than with a woman's personal space! My cousin's wife was induced and that led to a c-section on DEC 23rd. And my cousin overheard the nurses talking about how he had induced ALL of the women in his practice who were close....because he didn't want his Christmas to be ruined. NICE HUH? So if that is the standard of care then Dr. Biter is well outside of that... and I imagine that it causes no small amount of resentment. Really is kind of sad when you think about it... because the focus should be MOM and BABY! I hope that this is resolved soon though for those moms and babies who will be without him during this.

May 18, 2010 | Unregistered CommenterMelissa

What has really been on my mind in all this is where his upcoming birth center fits in. Surely the hospital is aware of it, and once it's open wouldn't he stop practicing at Scripps Encinitas anyway? Isn't that kind of a conflict of interest?

May 18, 2010 | Unregistered CommenterStassja

In not knowing the whole story I can only coment on what I have read here. I must say had I had a Dr like this when I gave birth to my first son it would have been a much happier memory in my life, but as it was I was treated as a statistic and very little of the procedures were explained to me and my birth experience ended with a c-section that I still have yet to heal completely from and that was almost ten years ago. My second child born five and a half years later was a great success I opted for a VBAC and was suprised at how difficult it was to find someone that would allow me to attempt to go this rout. I chose a midwife and she was so suportive of my labor and my delivery however as a result of my being a VBAC patient I encountered a steady stream of OB interfierence and the occasional surgical consult while in the L and D room not because things were going badly but because I had had a previous surgical delivery. My second son was born after 14 hours of labor and 20 min of pushing. Needless to say I will be doing a home birth next time with the aid of a midwife and my wonderful husband. We are our greatest health care providers and that is something we all need to learn. No one will advocate for us as well as we can. The world needs more health care profesionals that treat "clients" like People not a set of symtoms. Birth is nothing new womwen have been having children since the dawn of man sometimes we need medical intervention but I'm willing to bet it doesn't need to happen as often as it does.

May 18, 2010 | Unregistered CommenterHeather Fitts

So if I understand you correctly, Barb, you don't actually know why "Dr. Wonderful's" privileges have been suspended, but you suspect it is because:

1. He is not available to his patients in a timely fashion.

2. He has repeatedly violated hospital policies and placed hospital staff at risk of being sued. You mentioned elsewhere that he was aware that the suspension was a possibility, which suggests that he was warned and placed on probation, but ignored those warnings.

3. Even more disturbing, "Dr. Wonderful" has been accused repeatedly of inappropriate physical contact with patients. It is obvious from the photos that you took that he DOES have inappropriate physical contact with patients.

What I find particularly distressing is your awkward attempt to justify this touching. Like anyone who attempts to excuse inappropriate touching, you argue that the women "misunderstood," that they wouldn't have minded it if were another woman (but it wasn't another woman), that they wouldn't have minded if it had been another midwife (but it wasn't a midwife). These are the claims that are always made to justify inappropriate touching but they are usually made by people who think it is is okay to touch women whenever and however they want. I am very surprised that you would dismiss the concerns of other women with such classically sexist insinuations.

May 18, 2010 | Unregistered CommenterAmy Tuteur, MD

Seems like this is a sign that it's time for him to open his own practice... and, that "touchy-feeliness" is a show of love, for those who don't recognize it, love for LIFE!

May 18, 2010 | Unregistered CommenterDawn

My snarky remark is that he can the MD/OB and become a CPM. He probably has what in office politics is referred to as the "Hollywood Mystique" so dreamy is his practices that people think he is not all there.

Dr. Biter- the world needs more midwives. Good Luck- and it was great to see you in the pics Barbara.

May 18, 2010 | Unregistered CommenterSaanenMother

Hear about Dr. Colleen Murphy who was suspended from OB rotation because her c-section were too low, recently reinstated because there was no proof? (http://www.mothering.com/discussions/archive/index.php/t-316940.html) Sounds like he is merely in the same predicament, and Dr. Murphy got back her right to practice as there was no good evidence she should have been suspended in the first place.

May 18, 2010 | Unregistered CommenterEthel

I wish I could shout from the rooftops about several of the very pro-mother/baby friendly physicians that I work with. But if I did state specific names, I would be outing myself on my blog :-(

But, there are other good ones -- excellent ones! -- out there.

May 18, 2010 | Unregistered Commenteratyourcervix

I'm not the world's biggest natural childbirth fan....I did it 3 times, I'm an RN, and no way would I ever deliver anywhere but a hospital with continuous monitoring.....too much can go south too fast.

BUT...all a hospital needs is one or two documented allegations of inappropriate sexual or PERCEIVED as sexual contact and they can lose everything. Most hospitals now simply don't have that much margin for risk.....

May 18, 2010 | Unregistered Commenterfuzzy

For all his 'reckless' behavior, I have to wonder what his law suit rate is? I'm gonna take a guess and say it is lower than the OB who cuts a mom because he is worried about standing in that court room.

So really, who is right here? The doc who CARES about his patients and has results, or the docs who care about themselves and put their patients and babies at true medical risk?

May 18, 2010 | Unregistered CommenterSarah

However nice a guy Dr. Biter might be, it was inevitable. A doctor cannot behave unprofessionally, contradict the policies of the institution where he works, and still remain there. One breath of an accusation of improper "advances", or a suit which names not only the doctor but the hospital in an instance where his disregard for hospital guidelines results in a bad outcome or alleged malpractice, and the hospital is up s**t creek without a paddle, possibly even losing its accreditation, as well as the doctor facing disciplinary action, and/or massive fines. The fact that most of his patients like him personally is irrelevant. I've known doctors who were sued years after performing completely normal deliveries because of the parents' sudden perception that their little darling was 'slow" and it must be due to a labor which was "prolonged". The only wonder is that it took the hospital so long to decide that Dr. Biter was a catastrophe waiting to happen.

May 19, 2010 | Unregistered CommenterAntigonos

I did send Dr. A's and Antiginos' comments through (pretty much without hesitation), but am going to ask that as comments to *those* comments come, they remain civilized and ON TOPIC. If I see comments deteriorating to what I see on Dr. A's blog, they will not see the light of day.

Dr. A and Antiginos: I believe that what you have said deserves a blog piece all its own, so am going to jump off from your comments (still not 100% sure yet, but probably will) and write a new post. I will address your thoughts/concerns... and, shocking to me most of all, thanks for responding. You both bring up very important points.

May 19, 2010 | Registered CommenterNavelgazing Midwife

Safety and good outcomes, a birth that results in a healthy baby that you can actuallly take home with you. Isn't that the goal and every mother's right? Natural childbirth had been an integral part of Scripps Encinitas longer than 8 years...16 years actually and there are many doctors and nurses there that respect that still, and incoporate that style of practice into the care of their valued patients. VBACs still occur there as well when not contraindicated. Suspension of priveledge does not randomly occur over personality conflict or lack of popularity.As for the new birth center...that's a great service that will soon be available for those mothers desiring and qualifying for such a center...loss of business is definately not a concern. Those allegations merely distract readers from the truth. Check a recent article in the Union Tribune citing 4 active lawsuits in the last 13 mo.

May 19, 2010 | Unregistered CommenterAmanda R

Are you sure about the 31% c-section rate? When I was researching hospitals for my last pregnancy, the most recent published data was from 2006. I found the Scripps Encinitas rate to be at 19.5%-the lowest in San Diego County. It's sickening to see how much it's jumped up!

May 19, 2010 | Unregistered CommenterSummer

This is baloney. Why doesn't Dr. Wonderful release the allegations and evidence against him and defend himself on the facts?

It seems like the male perverts in OB have all realized that all they have to do is suck up to the midwifery fanatics and they will be supported and enabled for years to come.

How empowering. How pro-woman.

May 20, 2010 | Unregistered Commenter,

28.9% (I mis-remembered; I'll correct it) - http://www.theunnecesarean.com/blog/2010/4/9/california-cesarean-rates-by-hospital-2008.html

This is for 2008; 2009 is surely higher.

Long story of excuses that include having work, being out of the house and my computer running stupid things in the background that I *have* to get off has kept me from sitting down and writing responses... and the other post I feel formulation. Something like, "Hero Worship or Utmost Respect?" - probably not the end title, but something along those lines.

After my appt. this morning, I should be able to write more.

Sorry it's taking so long. Life and all.

May 20, 2010 | Registered CommenterNavelgazing Midwife

Thanks for this post. I also have an OB in my community that I've often described as "a midwife trapped in the body of a male obstetrician". He supports VBAC, homebirth, the midwifery model of care, vaginal breech and takes a hands-off approach to birth. He is despised by his colleagues, scrutinized by his hospital and has also been accused of being too "touchy feely" with his patients. Personally, I've witnessed this doctor climb onto a hospital bed and do an exam nearly bent over backwards to accommodate his laboring patient. If that's "touchy feely", I'll take it any day!

May 21, 2010 | Unregistered CommenterJen C.

Thank you for the c-section rates by hospital link, Barb! I hadn't seen any updated info for awhile. It's...horrifying, really. I found this news segment the other night: http://abclocal.go.com/kgo/story?section=news/health&id=7254194 California has a higher maternal death rate than Bosnia and Kuwait?! A big factor may be hemorrhage, particularly after a c-section. C-sections are clearly necessary in some cases, but there is absolutely no justification for the CA rate to be as high as it is. As a woman of child-bearing age, it really bothers and scares me that I have 1 in 3 chance of having a c-section if I birth in a hospital.

May 21, 2010 | Unregistered CommenterSummer

Can someone please directly address the issue of the six apparently pending malpractice suits against Dr. Biter? Yes, everyone gets sued, but that seems like quite a lot compared to average. What are they for? It isn't defamatory to post court filings; they're public information (but not available over the internet). Can't someone do just a little more information seeking and shed some light on this issue? It seems to be the most likely reason why he's been suspended. All of the cases are pretty recent (oldest is from 2005, most recent February 2010).

http://www.sdcourt.ca.gov/portal/page?_pageid=55,1056871&_dad=portal&_schema=PORTAL

May 21, 2010 | Unregistered CommenterJ

I see from the photos that Dr. Biter is very affectionate.Personally speaking, with pregnant, hormonal women, I think that, being he is a man, he should be much more careful. I would NOT liked being touched by an OB who is also very caring. Pregnant women are very vulnerable, and with a midwife, being a woman, it would be different. This isn't sexism, it's biology. I had an OB that was too emotional. It really bothered me. I think he got too attached to me and it was very uncomfortable. The delivery, which he wasn't even there for, was horrible, too. I think professional boundaries, with emotions and physical touch, should be carefully observed between men and women. Medical professionals should be above reproach in all ways.

May 21, 2010 | Unregistered CommenterLaura

I agree with you about the photos. Why is it so wrong when it's a male birth attendant, but completely acceptable for a midwife? Dr Amy is way off base here. It's only inappropriate when the patient feels so, not when onlookers with their own agendas do. It should be a patients choice who to see, not desk slaves in fancy offices who refuse to get their hands dirty.

May 22, 2010 | Unregistered CommenterMari

It's hard to address the lawsuits because I don't know about them besides what's been said in the news/press. Believe me, if I was privy, I'd be the first to explain things. I'm not much in the mind to be polite right now.

Laura - I understand your concern/thoughts... but, it is important not to superimpose your experience over everyone else's. Not everyone is uncomfortable with the amount of "affection" Dr. Biter shows his patients.

Re: "sucking up" to the midwifery community, that doesn't happen. When an OB garners respect from midwives/doulas, it is because they earned it.

I am right there with everyone, wanting to know details. I suspect we will *never* know The Facts. It agitates me no end. Here I've given my support - now, it seems, blindly. Frustrating doesn't begin to describe how I feel.

May 23, 2010 | Registered CommenterNavelgazing Midwife

You are right...unfortunately the support IS blindly given...the surface has barely been scratched. It seems hospital was kind enough to allow him to spare what he has of a reputation and allow him to resign...how professional and how classy of the hospital /medical staff. They only have the patient's best interest and safety in mind just as they always have. Natural births are still occuring at Scripps, even after all this...nothing has changed but the drama has finally ended. Scripps continues to put the patients first.

May 23, 2010 | Unregistered Commenteramanda R

I hear you. And I understand. Probably more than you would expect me to. I appreciate your words.

May 23, 2010 | Registered CommenterNavelgazing Midwife

"Not everyone is uncomfortable with the amount of 'affection' Dr. Biter shows his patients."

I hope that what you mean here is that every one of his patients (or a reasonably close percentage)is comfortable with him. This would necessarily mean that he is able to "dial it down" with more sensitive, less touchy-feely patients. If that's the case, then the inappropriate affection thing is probably a non-issue.

May 23, 2010 | Unregistered CommenterS

Thank you. I'm sorry for anyone that is experiencing deceit and disappointment.

May 23, 2010 | Unregistered Commenteramanda R

"... It seems hospital was kind enough to allow him to spare what he has of a reputation and allow him to resign...how professional and how classy of the hospital /medical staff." OK...I was too nice on this statement. THe medical staff SHOULD report this to the medical board since his actions or lack of are reportable.

May 24, 2010 | Unregistered Commenteramanda R

Amanda - I hear you... your anger and frustration are being heard. I do have to say that if lives were REALLY at stake, no deal would have been struck. If they were and SE cut a deal, then they are just as culpable as Biter. Just sayin'.

May 24, 2010 | Registered CommenterNavelgazing Midwife

I disagree that Scripps wouldn't have struck a deal if lives were at stake. While I am thoroughly disgusted by the unsupported allegations being hurled at Scripps, their primary objective is to ensure lives aren't lost on their watch, thus placing them in legal jeopardy. Their duty as an organization is to protect their patients, which they can claim to have done.

It seems likely to me that the deal--if one exists--was largely a result of public pressure, given the amount of local media attention this has garnered. The putative deal allows Scripps to wash their hands of him while being able to claim they didn't force him to leave.

If Dr. Biter is truly a danger to his patients--and I have no informed opinion on this--both Scripps and Dr. Biter's vocal supporters share the blame if a patient is ultimately injured because a thorough investigation was not done.

This is what I find most frustrating about l'affaire Biter, and I can only imagine how you feel about it.

May 24, 2010 | Unregistered CommenterSquillo

"Re: "sucking up" to the midwifery community, that doesn't happen. When an OB garners respect from midwives/doulas, it is because they earned it."

"I am right there with everyone, wanting to know details. I suspect we will *never* know The Facts. It agitates me no end. Here I've given my support - now, it seems, blindly. Frustrating doesn't begin to describe how I feel."

How exactly does one earn blind support?

The bottom line is the midwifery crowd doesn't care at all about the women and babies, especially not the ones harmed by their so-called movement. All they want to do is control other women and monopolize birth.

All you are doing is creating a sham industry of standing around for births that were selected out as the ones most likely to not need any help in the first place. It's more about your obsession with the birth process, than helping women.

When a problem rears its ugly head, you guys don't know it and/or don't know what to do and nature takes its much more deadly course, in these case. In the aftermath, you throw the victims under the train. "It would have happened in hospital." "She's suing over grief" "She didn't take responsibility for her birth and call 911 herself." (BTW, if moms are suppose to recognize problems and call for help themselves, what exactly do they need you for?)

Part of this is blindly defending any doctor that enables you.

May 26, 2010 | Unregistered Commenteranon

I was just wondering why your other post about him was taken down?

May 28, 2010 | Unregistered CommenterErin

For a variety of reasons. The main one is I am tired and need a break.

May 28, 2010 | Registered CommenterNavelgazing Midwife

What has happened in NYC , they disconnect from the hospital culture and health insurance business practices.

We have a OB, she does not take any health insurance, all clients are self pay, and she delivers in a hospital birth center.
She also is the only doctor in our city to deliver vaginal Breech.

Some of the RN's make what they think are derogatory comments about her all the time that she" practices like a midwife".

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