Study Finds Neonatal Care Excessive

From a May 15, 2002 Associated Press story reported on the MSNBC website comes the above headline with a story that starts, “Specialty has mushroomed into too much of a good thing.” A study of newborn death rates at Dartmouth Medical School in Hanover, N.H, found that there were few differences across the country of newborn death rates regardless of the extent of neonatal care specialties available.

With the exception of the areas that the researchers identified as having very few specialists the study suggests there are far too many doctors and hospital units specializing in intensive care of premature or sickly babies. The results of the study showed that once a certain threshold of care is reached, having even more doctors offers no extra advantage or additional protection to newborns.

The AP article stated that, “This oversupply is not only a profound waste of medical resources, it may also be harmful, because it may subject babies to unnecessary tests and treatments.” Dr. Kevin Grumbach, a public health researcher at the University of California at San Francisco, commented on the study in an article he wrote in the New England Journal of Medicine. In his response he wrote, The researchers “raise disturbing issues regarding the nation’s unquestioning acceptance that more is always better with respect to the supply of specialist physicians and hospital technology.”

The results of the study showed that, newborns in areas with a very low number of doctors, such as a ratio of 2.7 for every 10,000 births, had a slightly higher death rate than normal. This translated into a 7 percent higher death rate than in better-equipped areas. On the other hand, areas with a supply of doctors ranging from 4.3 to 11.6 neonatologists per 10,000 births all had about the same death rate. Even the most premature babies were found to die at roughly the same rate in these areas. This basically showed that after a certain point, more is not necessarily better. Dr. David Goodman, the pediatrician who led the study said, “Enough may be enough.”

The article reported that the researchers claim that because of the oversupply, some healthy newborns may be subjected to unneeded tests and treatments that can produce harmful side effects. Dr. Grumbach said. “If I have a healthy full-term baby, I actually don’t want anyone messing around with that baby. There’s a downside where we meddle too much.”