title: Team obstetrics and the nurse-midwife. Issues in patient acceptance.
abstract: In this discussion we have presented findings from a study of patient acceptance of a nurse-midwife. The significance of the initial encounter for patient acceptance has been interpreted in terms of a primacy effect. The negative effect of the obstetrician's presence during initial encounters between patient and nurse-midwife has been discussed in terms of expectation theory. The theory leads us to predict that the patient's perceptions of competence of the nurse-midwife were more favorable when the obstetrician was absent from the initial encounter than when he was present. Finally we have interpreted the overall ease of communication between the nurse-midwife and patients as a result of mutual participation, and complementary rather than crossed interactions. This ease of communication is a major factor accounting for the general enthusiasm of patients for the nurse-midwife in the provision of office care. The importance of interpersonal relationships between health professionals and patients for effective patient care cannot be overstated. Romano has stressed the importance of the doctor-patient relationship in obstetrics and gynecology because of the many anxieties and concerns of women concerning their health problems. Hopefully, our findings will encourage physicians to explore the role of mid-level health professionals and particularly nurse-midwives in enhancing the overall quality of health care for women.
mesh_terms: D003142:Communication; D005260:Female; D006801:Humans; D009723:Nurse-Patient Relations; D009774:Obstetrics; D010342:Patient Acceptance of Health Care; D010820:Physicians; D011247:Pregnancy; D012938:Social Perception; D014152:Transactional Analysis