Monday, November 30, 2009

Entrepreneurial Birth Versus Institutional Birth

Why are women, generally happier with the care they received at a birth center or homebirth as opposed to the hospital?

Many of you will list reasons such as: less interventions, empowerment of women, comfortable surroundings, individual care, and a host of others.

Allow me to introduce a different concept. In fact, it is a business concept. A hospital is an institutional form of business, while a birth center or homebirth is entrepreneurial. Quite simply, the birth center midwife or homebirth midwife is an entrepreneur (some midwives are birth center employees, however, birth centers usually operate at or near breakeven, thus a midwife employee feels like an owner or manager) , where the hospital is an institution.

You are dealing with Mary the midwife, who may be the birth center owner. In the hospital, most of your contact is with a L&D nurse, who you probably do not know. You probably do not know her, nurse manager, and most definitely do not know the hospital CEO or president.

Mary the midwife will treat you well, not only because she really cares about your birth, but also because she cares about her business. If you have had a problem with your care, you will tspeak to Mary. If you have a problem in the hospital, you will speak with some bureaucrat. To Mary, you are special! To the hospital, you are another patient.

Some physicians practices are still entrepreneurial and others are now owned by the hospital and are institutional.

Which model is more likely to try to meet your needs? Institutional or entrepreneurial?

Tomorrow, we will put some dollar signs into the models.


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