The story of the pharmacist in Montana refusing to provide contraceptives (even to a woman who was using them not as contraceptives but to address other medical issues) is one of many similar stories.  It will be interesting to see whether the media-attention has any impact either directly (by changing their minds, doubtful) or indirectly through loss of business the way it did on walmart a few months ago.

In any event, it reminded me of a similar experience I had when I first came to this small city.  When I arrived, I had, in addition to a 2.5 year old, a five month old baby. A month or so later I stopped breast-feeding and wanted to resume birth control pills (which you can’t take while Bf-ing).  A neighbor, an older lady*, recommended a local ob/gyn practice.  I called them up and was informed that they were not taking new patients at the moment because one of the doctors was on maternity leave and suggested I call back in a month.  I was ok with this because in my own rough research, this was the closest ob/gyn practice that had women doctors, which I greatly preferred for this particular service, so I waited using non-presciption methods in the meantime.

So a month goes by, I call, they take various information from me and then ask why I am seeking an appointment.  I reply that I have stopped breast-feeding my second child and want to go back on birth control.  At which point, they said, “Oh we don’t do that here.”

“Uh, excuse me? You are an ob/gyn practice, right?”

“Oh yes, but we are affiliated with [local catholic hospital] and we don’t do that type of thing.” 

Oh, so really they are only a ob practice, not an ob/gyn practice

I ended up at another local practice with guy doctors that frankly I’m not thrilled with, but they have an awesome female nurse practitoner and I get the contraceptive prescriptions that I need.

But.  And I have had this discussion a couple of times with doctor friends who disagree — IMO, you have no business doing an ob/gyn practice if you are not going to offer full services.  IMO you have no business being a pharmacist if you are not going to offer full pharmacy services.  The only exception I might permit (if I were chief goddess) is if, the second that doctor’s office had answered the phone they had said, up front (rather than wasting a month of my time) We offer only limited services.  Even then I think there are certain obligations you have if you are going to set up in an area where the pool of medical professionals is limited.

But still, there is something wrong with this.  There are a million areas of practice in medicine.  Why go into a particular area of practice when you won’t provide services considered basic to that practice field.   There is the argument that you can go elsewhere, but really, in smaller towns, particularly conservative ones, you don’t have a lot of options. 

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