There are some Major Problems at UCSD Women's Health

Recently my wife and I were subjected to almost 4 weeks of horrific treatment at the hands of University of California San Diego (UCSD) Women's Health when she became pregnant and the pregnancy was suspected to be ectopic. Below find a list of issues in no particular order. Because the screw-ups were so egregious I am calling out the clinic by name and urging anyone who reads this to avoid them at all costs.

1. Dr. Go-round

The first Doctor we saw was Dr. [redacted for sake of anonymity]. We liked her. We saw her twice and assumed she was our doctor. Suddenly when we needed her she was not available. Turns out she was on vacation which I totally understand and do not begrudge her. However, she returned from vacation well before the end our recent saga and yet we never saw nor heard from her again. Meanwhile we were treated to a parade of at least 3 different OBs, each of whom was less reassuring and seemingly more incompetent than the last.

2. Feeling driven decision making vs. data driven decision making

From each of the various doctors we saw we were treated to a litany of analyses of the situation that began with the words "I feel that.. or we feel that.." I am a research scientist. In the workplace if any of my colleagues begin a sentence with the words "I feel" I immediately tune them out because I know that what comes next will almost certainly be biased and probably also incorrect. Medicine, like science, is based on facts, not feelings, or at least it should be. Not to put too fine of a point on it, but I do not care how you feel about the data, I need to know what hypotheses you have generated and how you plan to test them and/or react based on that data. As far as I could tell their was only one hypothesis through this entire fiasco, that it was an ectopic pregnancy in the right fallopian tube. Unfortunately, it was pronounced as a matter of fact and not as a hypothesis and even when data point after data point failed to support that hypothesis it was treated as if it must be absolutely correct. Even worse, when it was actually proven incorrect, rather than an apology and promise to do better next time, instead we were presented with a parade of excuses each less plausible than the next as to why you got it so wrong.

3. Lack of respect for patient's intelligence and no belief in their ability to contribute to finding a solution to the problem at hand

I understand that many of the patients you deal with are less well educated or even have no scientific or medical knowledge. However, that was absolutely not the case in this instance. In fact, you have no idea who you were talking to and never even bothered to try and find out. Not once did you enquire about either of our backgrounds. If you had you may have learned that Jen is a polymath and child prodigy who skipped high school to graduate college at age 18. She went to law school and medical school and is currently a highly respected research scientist with expertise in infectious disease and immunology. I can't claim the same pedigree as my wife in terms of medical training, but I do hold a PhD in microbiology/molecular biology and have been employed in various roles over a 20+ year career in research and development. We have access to all of the same primary technical and medical literature you do and we are more than capable of reading and understanding it. Between the two of us I would argue our knowledge meets or exceeds that of most of your doctors or residents. That belief was bolstered by the many misstatements of facts and misunderstanding of the most current practices and procedures of obstetric medicine that were made by various doctors during our many interactions.

4. Fear mongering

One thing your doctors were very good at was inspiring fear. The warnings of imminent doom if we did not do exactly as your doctors demanded, exactly when they demanded it were unconscionable and caused myself and my wife many sleepless nights. Fortunately we are knowledgeable and were able to quickly dispel the most dire warnings relatively quickly with a quick check of the literature and review of the facts, but the fact that we had to do this is unforgivable. I can't imagine how a patient with zero knowledge would respond to this sort of treatment, but it must be truly awful.

5. Incorrect factual statements of a very basic nature

"You are too old to get pregnant", "You can't do IVF at your age" are only two of the choice misstatements of facts said to my wife by the doctors at UCSD women's health. Also see above section on fear mongering.

6. Using the ER as your clinic

I know you are busy and have a long wait times to see doctors at your clinic but sending patients to the ER for every visit because of it is simply not acceptable. I know the ER doctors do not appreciate it and we, the patients, appreciate it even less.

7. Not wearing PPE (at all), and having way too many people in the room during an invasive and painful surgical procedure which turned out to be unnecessary

Ill get to the fact that the procedure was unnecessary but seriously?? no PPE?? Of the six people in the room only the doctor performing the procedure wore nitrile gloves and that was it. No safety glasses, no smocks, no hair nets, no face masks, nothing worn by anyone else in the room. As a microbiologist with an understanding of the routes of pathogen contamination during a procedure with a demonstrable risk of infection, I was appalled and disgusted by this terrible show of clearly not following procedures. At least I hope it was a case of not following procedures but given everything else it would not surprise me if there are no procedures and this is deemed a valid practice. I absolutely would have said something had I been one of the six people in the room. Strangely, I felt I would only get in the way and that my being there would present additional unneeded risk, but given what transpired, my presence, would have been the very least of the issues.

8. Not consulting with internal specialists and then flat out lying about it and saying you did

We asked the hematology department if they had been consulted. They said no one from UCSD OB-Gyn had contacted them. You told us you had discussed the issue with them. Why lie, especially about something so deadly serious? Fortunately my wife did consult with hematology and followed their advice which was the exact opposite of your advice. Following your advice could have resulted in the death of my wife. But, at least you saved face by lying about it. WTF?

8. Ageism

See #5 above. Despite what the literature demonstrates unequivocally we were told over and over again by multiple doctors how unlikely it was that we could ever have a healthy pregnancy because of our age. We were also told that IVF was not an option because of our age. Overall it felt like because of our age the doctors at UCSD felt we were not worth any effort at all. "Why bother? They are just too old", seemed to be the prevailing "feeling" among the doctors. See #2 above for more on the "feelings" issue.

9. Making a huge error

The ectopic was in the left ovary NOT the right fallopian tube. Our OB in Mexico spotted it in the ultrasound less than 10 minutes into our visit with him. He showed it to us in the images and it was crystal clear and unequivocal. You missed it. How? I suspect it was because you had already made up your minds that it was in the right fallopian tube and also that you only read the radiologists summary of findings and never actually looked at the images. Unbelievable, unforgiveable, and a horrific error which resulted in my wife being subjected to a totally unnecessary and painful medical procedure which was also chock full of problems for other reasons (see #7).

10. Not admitting the error

See #2 above. You screwed up. Admit it, apologize and then make sure it doesn't happen again. This will require serious investigation and self examination. I have zero faith that such an investigation will happen but that is what a normal, competent, well respected medical system would do in such a situation. Clearly, UCSD women's health does not fall into that category.

There were many, many more problems I could detail but I am so frustrated and angry and saddened by what happened at the moment that I cannot go on. All I can say is if any administrators at UCSD medical system happen to read this I urge you to take immediate action to correct the many, many problems in your Women's Health department. It is in terrible shape and is in grave need of a massive overhaul. Good luck, you are going to need it.