Yvonne S. Thornton

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Yvonne Thornton on the Dr. Nancy Show: Should Pregnant Girls Play Contact Sports?

Thursday, December 10th, 2009

Today on Dr. Nancy, I was invited to appear to discuss a controversial issue. A young pregnant woman, whose high school took precautions against injury to her fetus by treating her differently than other girls on her volleyball team, has filed a complaint, claiming discrimination.

On the show, Dr. Nancy and I explained why this isn’t a discriminatory action but an appropriate one that protects the health of mother and fetus. Although some may not think of it this way, volleyball can be a contact sport. A player can get an elbow shoved into her abdomen when someone else reaches for the ball. A player can get pushed down on the court. There is always risk of injury but for most young women, the risk is minimal. Not so with a young pregnant woman. She risks harm to her fetus in the rough and tumble of such competitive sports.

While exercise is good for a pregnant woman’s health, contact sports are not, certainly not when the sorts of things we see happening in games have the potential to injure a fetus.

This isn’t a women’s rights issue. Dr. Nancy and I are both staunch defenders of women’s rights. It’s about keeping a baby and mother safe.

- Yvonne S. Thornton, MD, MPH

Labor & Delivery: Don’t try this at home

Monday, November 30th, 2009

Most women today have no idea how dangerous it once was for a woman to give birth. The maternal death rate today is about eight per 100,000 births.  When home births were in style, the maternal death rate was 83 per 100,000 births – 10 times the number of deaths.

Women today almost never die in childbirth because, when things go wrong during labor and delivery, medical professionals can step in and prevent emergencies from becoming tragedies.

Which is why I want to scream when I read nonsense like the following, from a website calling itself “Born Free.”


“Welcome to Bornfree! This site is based on the belief that childbirth is inherently safe and relatively painless provided we don’t live in poverty, and do not interfere either physically or psychologically. Drugs, machinery, and medical personnel are not only unnecessary in most cases, they are also no match for a woman’s own intellect and intuition.”

The site quoted above advocates for unassisted childbirth at home. No doctor. No midwife. And no professional help at the ready if something goes wrong.

Ordinarily, I wouldn’t get too exercised over an obscure website. But, it’s how I found this website that has me troubled. It was featured in an article on ABC News.com in the “Entertainment” section. The article mostly extolled the concept of women giving birth at home, with neither a midwife nor a doctor present, giving only the briefest nod to the caveats from an ob-gyn.

In the age of reality TV, maybe a piece about women risking their lives to experience “freebirth” makes good copy. Maybe, because it was in the Entertainment section, this quote from a mother who recently gave birth on her own didn’t raise any eyebrows: “…it is not risky if you do your homework.”

But ask an ob-gyn and you’ll get a much different albeit less entertaining quote.

Yes, so-called “freebirth” is risky. And no, you can’t mitigate the risk by doing “homework.” Approximately 40 percent of high-risk patients appear to be low-risk before labor and delivery. No amount of “homework” can prepare a woman for suddenly finding herself among those 40 percent. If she’s at home, without medical attention, she and her baby could be in serious danger.

Most certified nurse midwives are affiliated with hospitals today precisely because the unexpected can and does happen during childbirth and having medical and surgical teams within shouting distance can mean the difference between life and death. The birthing process is still the 11th leading cause of death in women between 15 and 44 years of age.

When I was in the military, we received a stat call about a home birth gone wrong. The woman lost all muscle tone in her uterus after the birth of her child. By the time the ambulance got her to Bethesda, she had bled to death.

So I’ve seen firsthand how “freebirth” can be a recipe for disaster.

- Yvonne S. Thornton, MD, MPH

Halfway to realizing real health care reform

Wednesday, November 11th, 2009

This past weekend, in the House of Representatives, our congressmen and congresswomen came together to pass a bi-partisan bill. In doing so, they took the first step toward ensuring that all Americans have access to health care when they need it.

If a final bill passes that includes the provisions of this bill, here’s what we can all look forward to:

* No more lifetime or annual caps on how much treatment health insurance will pay for. This is so very important for men, women and children with chronic illnesses, who often see their claims for care denied, just when they need it most.

* No more denial of insurance coverage for pre-existing conditions. As of right now, some health insurers consider having had a cesarean section a “pre-existing condition.” They deny claims to victims of domestic violence, calling it a “pre-existing condition.” Even perfectly healthy babies who are a bit chubby have been turned down by health insurers who claim their weight is a “pre-existing condition.”

* Adult children would be allowed to remain on their parents’ policies until age 27.

* Seniors on Medicare would pay less for prescriptions.

* And all would get a genuine choice of health insurance options, available from both health insurance companies and a government-administered plan (the public option).

None of us should have any illusions that this first step toward making health care affordable and available to all will make the next steps any easier. Powerful interests, particularly those of health insurance companies, will fight all that much more aggressively to prevent the senate from passing its own version of reform. Health insurers’ profits are as high as they are because they get to cherry-pick who they will and won’t cover; because they can refuse to provide care after someone has reached the annual or lifetime coverage cap; because they can call almost anything a “pre-existing condition.”

Through misinformation campaigns, spread by surrogates, these powerful special interests have done all they can to frighten Americans into believing that health care reform will be bad for them and for America. The misinformation often mirrors that which was spread back in the 1960s in an attempt to prevent Congress from passing Medicare.

As a physician who has seen, firsthand, how the lack of health insurance can devastate families, I know that we must fight back aggressively against the special interests. We must become informed about the realities of health care reform and help our friends and families understand the difference between information and misinformation.

This opportunity to provide health care for all may not come again for many years if it doesn’t succeed now. And if it fails today, next time, the fight will be even harder and will stand less chance of success.

As a doctor, a woman, and a mother, I urge our senators, no matter their party affiliation, to stand with our families and help us protect them when they are most vulnerable. And I urge my readers to contact their senators and tell them that nothing is more precious than health – and nothing more important than passing reform so that families can get the help they need when they need it.

- Yvonne S. Thornton, MD, MPH

ANNOUNCING: My new memoir, the sequel to The Ditchdigger’s Daughters, to be published by Kaplan Publishing

Monday, October 26th, 2009

This is the news I’ve wanted to share with you for months but I had to wait until the contracts were signed. Now I can shout it to the world.

My new memoir, SOMETHING TO PROVE: Memoirs of a Ditchdigger’s Daughter, by Yvonne S. Thornton, M.D., with Anita Bartholomew, will be published by Kaplan Publishing in Fall 2010.

The book sold at auction, meaning that more than one publisher wanted to publish it. I decided to accept Kaplan’s offer over the others because the team at Kaplan really seemed to get what I was saying and what I was about. And Kaplan has published a number of other memoirs by physicians and medical professionals, so I feel that it’s a good match.

SOMETHING TO PROVE: Memoirs of A Ditchdigger’s Daughter, builds on the foundation of my earlier book and shows that what was true as I was growing up is true today: despite bias, despite setbacks, with hard work and determination, we can accomplish whatever we set out to do.

The book begins with the challenges I encountered when, in the early 1980s, I entered what was still an all white boy’s club of academic medicine. Although I faced bias for both my gender and color, I had a secret weapon: my father’s wisdom. The essence of what he drummed into me as a child was that, as a female, and an African-American, I’d have to work twice as hard as anyone else to be thought to be half as good (a sentiment that later became a mantra for the women’s movement). And I did.

SOMETHING TO PROVE will also document how I handled the personal struggles that every working mother must confront, of juggling a career and family life.

And because I’m a specialist in high-risk pregnancies, SOMETHING TO PROVE will offer plenty of edge-of-your-seat medical drama.

It won’t focus solely on the challenges though. Yes, I’ve dealt with setbacks and pain, but I have also enjoyed great success in my career. I have a supportive, wonderful husband, and two children who are poised to follow their parents into careers in medicine.

And that’s the ultimately uplifting message of SOMETHING TO PROVE, in life lessons passed down from my father to me, and from me to my own children.

It’s been a great journey and I look forward to sharing it with you in SOMETHING TO PROVE.

- Yvonne S. Thornton, MD, MPH

A reader “adopts” my father

Friday, September 11th, 2009

I recently heard from a reader of The Ditchdigger’s Daughters, named Sheila. Like so many who have sought me out over the years, Sheila had words of admiration for my father. But for her, my book about how my blue collar laborer, high school dropout father instilled the importance of an education is his daughters provided an especially poignant inspiration:

I grew up in the projects and never had a father. I purchased your book and Donald Thornton became my father. Whenever I wanted to give up or thought I was not smart enough I would remember his stern words and teachings. Your dad is the father every little black girl in America needs. I am soon to finish my Bachelors Degree in Nursing and going for a Ph.D.

It’s letters like this that keep me going through the tough times, knowing I’ve made a difference in the lives of others by sharing my story.

And that’s why I wish I didn’t have to wait to announce some major, and very exciting news. I hope you will bear with me for a little while longer. That announcement should be coming very soon.

- Yvonne Thornton, MD, MPH

Lawmakers: direct-to-consumer ads for prescription drugs are a problem

Friday, July 31st, 2009

As I’ve written before, I am troubled by direct-to-consumer advertising of prescription drugs. Only a doctor who knows your medical history and has done and interpreted any necessary tests can determine whether you need a prescription drug and which one you should be taking.

Now, a few lawmakers have proposed bills that would help limit this practice. Here is an excerpt from a New York Times article about the legislative proposals:

“For some legislators and consumer advocates, the ads are a daily reminder of a health care system run amok. Critics contend that drug ads are intended to prompt people to diagnose themselves with chronic quality-of-life problems like insomnia or restless leg syndrome; lead people to pressure their doctors for prescriptions for expensive brand-name drugs to treat these conditions; and steer people away from cheaper generic pills.


“And, critics say, such ads may overstate benefits and understate risks of drugs, or by drumming up audiences for the latest pills at a time when the side effects of such drugs may not yet be fully known.”

I agree with all the above and hope that Congress will act. One suggested bill would deny pharmaceutical companies a tax break for the cost of creating and running such ads. That sounds like a good start. The rest of us shouldn’t subsidize these direct-to-consumer ads through our tax dollars.

- Yvonne S. Thornton, MD, MPH

A blast from my past

Tuesday, July 28th, 2009

Those who read my first book, The Ditchdigger’s Daughters, know that my parents, a blue-collar laborer and a domestic, valued education above all. They knew it was the way to a better life for their daughters.

But how did they find the money to put five girls through college, with four of us going on to get advanced degrees in medicine, dentistry and law?

We spent our weekends touring as The Thornton Sisters, playing for college dances, appearing at the Apollo, and recording records.

I’m writing the above because I just discovered that, 44 years after we recorded it, an old Thornton Sisters record is playing on YouTube.  Who would have thought it?

- Yvonne S. Thornton, MD, MPH

Why your Ob-Gyn should be board-certified

Wednesday, July 22nd, 2009

It’s almost impossible to judge a professional’s skills if you’re not a member of that profession. Only a radiologist can say whether another radiologist accurately read a CT scan. Only a dentist can attest to the quality of the crown another dentist fits over a molar.

So how do you, a layperson, judge the qualifications of your doctor? If they drive fancy cars, wear designer clothes, and charge the highest fees in the community, you can be sure they’re successful. But does that mean they’re qualified? You can ask your girlfriends or your sister or mother to recommend someone. You can determine whether you have rapport with a physician. But that won’t tell you about qualifications, either.

If you want to know whether the kind, caring person you select has the minimum qualifications, there’s one way to determine that. Go here to see whether your doctor is board-certified.

Board certification isn’t mandatory. Once a doctor gets a medical degree and a state license to practice medicine and surgery, he or she can practice any specialty. No law requires a doctor to complete a four-year residency in a specialty, such as ob-gyn, in order to be called a specialist. Nothing prevents a doctor from giving him or herself the title of obstetrician or fertility expert or perinatal specialist or really, almost anything.

But only board certification assures you that the doctor has earned that title.

A board certified doctor has gone a giant step further than a physician who hasn’t passed her boards. After completing a residency program, passing a written test in the specialty, and practicing for a year or two, she’s gathered up all her cases and submitted them to an august body known as the American Board of Obstetrics and Gynecology. Before these distinguished university professors and chairs of departments, she’s been extensively questioned about real and hypothetical situations and asked about diagnoses, patient management and treatment.

As an oral examiner for the American Board of Ob-Gyn since 1997, I’ve certified hundreds of new ob-gyn candidates who have proven their capabilities under difficult circumstances. And there were some who did not pass because they didn’t meet those high standards.

So I speak from experience when I say that board certification is the minimum you should expect from your doctor.

- Yvonne S. Thornton, MD, MPH

Only in America: insured – but bankrupted by medical bills

Wednesday, July 8th, 2009

There was a story recently in The New York Times about a married couple in Austin, Texas, who thought they were covered by medical insurance. They discovered otherwise when one of them actually needed to use it:

“Too many other people already have coverage so meager that a medical crisis means financial calamity.


One of them is Lawrence Yurdin, a 64-year-old computer security specialist. Although the brochure on his Aetna policy seemed to indicate it covered up to $150,000 a year in hospital care, the fine print excluded nearly all of the treatment he received at an Austin, Tex., hospital.


He and his wife, Claire, filed for bankruptcy last December, as his unpaid medical bills approached $200,000.”

You might assume that, because both my husband and I are doctors, affiliated with two of New York’s most prominent hospitals, we’d never face the issue of inadequate insurance.

If so, you’d be wrong.

When my daughter was in graduate school, she became ill and needed to be hospitalized. She had health insurance through her school. Her hospitalization, CT scans, and other tests, were covered.

But the hospital discharged her before she was completely well and she continued to have severe pain. That’s when we learned that her medical expenses under her policy were capped at $25,000 – and she’d used up the maximum during her first hospital stay.

Because my husband and I had the resources to cover the staggering bills that resulted – physicians, another hospitalization, surgery, tests – our daughter was able to get the care she needed and not go into debt.

But what if we couldn’t be there for her?

It’s not unusual for people, even those who are insured, to lose everything once a major illness strikes. I know of one couple in Michigan. Both had good jobs and health insurance. Then, she got cancer and he needed a heart bypass. His treatments were only partly covered and they fell into debt. They lost their jobs and with it, their insurance. They went bankrupt, lost their home, and just about everything else.

I wish I could say this was unusual but it happens all the time. A recent study showed that 62 percent of bankruptcies in the U.S. in 2007 were due to medical costs. What’s more alarming is that, at the time those people became ill, 78 percent had health insurance. They either lost it when they lost their jobs due to illness or it was inadequate to cover their medical expenses.

And this should illustrate, as nothing else can, why this country desperately needs a public option in healthcare coverage, one that can’t be taken away if you’re too sick to work, one without the fine print that explains how the insurance company isn’t going to cover you when you most need it.

I know there are politicians in Washington, making all sorts of arguments about how, if we allow a public option, we’re on our way to socialized medicine or rationing or, who knows what the latest nonsense is. I’m here to tell you that that’s all it is: nonsense.

These guys rake in tons of money from the health insurance lobby and others who want to keep making huge profits by denying you care when you need it most. Don’t let them fool you as they’ve fooled the American people for so many years. Call your senators and tell them you’re mad as hell, and you’re not going to take it any more. Tell them that all you want from them is a public option so you can be certain help will there when you need it to keep your family well.

- Yvonne S. Thornton, MD, MPH

A letter from a reader that touched my heart

Wednesday, June 10th, 2009

I usually blog about women’s health but I wanted to depart a bit from that today because of a letter that a young woman named Jacinta sent me.

Jacinta read my memoir, The Ditchdigger’s Daughters, and found in the story the encouragement she needed to become a doctor herself. But let me allow her to tell it in her own words:

“I am 19 years old. I just finished reading your book and it truly inspired me. I want to work with children in the medical field and reading about the obstacles that you overcame to work in the medical field really encouraged me to work harder to accomplish my dream. The thing that really encouraged me was at the end of the book when you and your sisters were sitting around reminiscing about the things that your dad had taught you down through the years … ‘Daddy was the bow, we were the arrows and he aimed high. He didn’t say midwives, he said doctors. He didn’t say dental assistants, he said dentist.’ He always encouraged you all to be leaders and to be the best at whatever you did. That really stuck with me when I read it.


“I can be a leader. I love kids and I always knew that I wanted to work with them, but I never really decided how I wanted to work with them. So I decided that I would either be an obstetrician or a pediatrician.


“… I watched your interview on C-SPAN and I remember you saying that your father told you that the only person that can stop you is you. Well I’m not going to let me stop me so I decided to work towards all my dreams.”

As those who have already read The Ditchdigger’s Daughters know, my father was a blue collar laborer and my mother cleaned houses for a living. But they were determined to see their five daughters do better. They insisted that we work hard, get as much education as we could, and aim for the top. My father had a dream that we would all become doctors. Two of us are physicians now, one is an oral surgeon, another became a lawyer with a Ph.D.,  and one, a court reporter.

I want to take this opportunity to speak to all those like Jacinta, whose families may not have all the advantages. You can make a better life for yourself. If my sisters and I could do it, you can do it. Believe in yourself and be willing to work harder than you ever imagined possible. Then, work harder still. Stay in school, study like your life depends on it (because, in a way, it does), and don’t let anything hold you back, especially not your own negative notions about the limits placed on you from the outside.

And I want to say thank you to Jacinta. Knowing that my book touched you means so much to me.

It’s letters like yours that have inspired me to begin working on a new memoir that picks up where The Ditchdigger’s Daughters left off. I hope that this book, too, will persuade readers to reach higher, study harder, and pursue their dreams.

- Yvonne S. Thornton, MD, MPH