Take a Close Look

THE NEWS TWO WEEKS AGO that University Health Services (UHS) had recently investigated its gynecologic practices for trouble was certainly shocking, but in all likelihood, few people were actually surprised.

Harvard has grown accustomed to hearing scattered rumors of UHS inadequacy over the years. For most people here, the news that last spring's investigation had all but dismissed the complaint that a UHS gynecologist had performed too many Caesarian sections was probably a much greater matter of concern. So was the fact that Dr. Warren E. C. Walker, director of UHS, and Dr. Kenneth J. Ryan, head of gynecology and obstetrics at Harvard-affiliated Brigham and Women's Hospital--where the disputed operations took place--say they are now satisfied that nothing is amiss.

The group that lodged the formal complaint against UHS--the Medical Area-based Joint Committee on the Status of Women--has similar doubts, and so do we. Charging Wacker and BWH have responded insufficiently to their allegations, members of the committee have renewed their demand that UHS disclose some annual gynecological statistics which they say may well support their charges. More significantly, they have said they lodged the complaint--based on anonymously mailed statistics on delivery-rook records--primarily to draw attention to what they call a wide variety of complaints about the same doctor, Paul I. Winig '62.

At issue in the Winig inquiry is the delicate matter of how much to trust statistics. The Joint Committee's figures show that Winig's Caesarian section rate, when compared to that of his colleague Dr. Jerome Federschneider, show markedly more readiness to perform Caesarian sections. The formal grievance calls for a comparison of Winig's rate of Caesarians with the rate for all of BWH for a year--a figure still forthcoming.

Wacker and Ryan, on the other hand, argue that despite the statistics, every one of Winig's Caesarian sections checks out as medically appropriate. Given that fact, they contend, statistics don't matter, especially over so short a period. The women's committee retorts that with all other complaints dismissed as "attitudinal" conflicts, stemming from UHS "traditional" approach to birthing, statistics are the only evidence that can stick.

By arguing exclusively on the Caesarian section complaint, the Joint Committee appears to be letting slide other gripes women have voiced about UHS. If the problem is as widespread as the range of complaints attest, then statistics or no the committee should push for a more comprehensive investigation.

Though numbers seem intrinsically "harder" than anecdotes, it's quite possible that the matter of Caesarian section frequency is not the best way to approach a problem of alleged malpractice. Difficult and embarrassing though it may be, more women must follow the lead of their courageous colleagues and come forward to press their cases. If true, the problem is too serious to lose sight of.