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Guidance please (WARNING: LONG)

Home Practice Management Guidance please (WARNING: LONG)

  • Avatar mainah 
    Participant
    Status: Advanced Practice Provider
    Posts: 40
    Joined: 10/04/2018
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    I think you are young.  Your efficiency in seeing patients and procedures will improve with time.  I also agree with the above comment that no one expects you to read 500 pages of medical records.  Look for the most recent summary, problem list, meds etc.  If you need something specific you can hunt for it.  Have patients come early to fill out paperwork is great or even better mail it to them.  Hang in there.

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    Thank you for your encouragement. So you’re saying that it is an inefficiency issue with me, not being able to room my own patients, enter in meds and allergies at the very least, and then have a productive conversation about their T2DM/HTN/COPD/health maintenance in 15 mins? (and be honest :)). I feel like I was able to get patients in and out in 20 mins at my last clinic with good MA support, but didn’t know if that was an anomaly and my current situation is the norm.

    And that’s exactly what I ended up doing with that 500 page stack of records, and had to tell the patient “I’ll have to get back to you about that” a couple of times when she asked questions about different tests she had or different meds she had been on and why they were changed. There was no way I was going to be able to hunt down specific items quickly the way the chart was sent in the 15 mins I had with the patient

    #180695 Reply
    Rando Rando 
    Participant
    Status: Physician
    Posts: 204
    Joined: 01/08/2016
    Click to expand

    Thank you for your encouragement. So you’re saying that it is an inefficiency issue with me, not being able to room my own patients, enter in meds and allergies at the very least, and then have a productive conversation about their T2DM/HTN/COPD/health maintenance in 15 mins? (and be honest :)). I feel like I was able to get patients in and out in 20 mins at my last clinic with good MA support, but didn’t know if that was an anomaly and my current situation is the norm.

    And that’s exactly what I ended up doing with that 500 page stack of records, and had to tell the patient “I’ll have to get back to you about that” a couple of times when she asked questions about different tests she had or different meds she had been on and why they were changed. There was no way I was going to be able to hunt down specific items quickly the way the chart was sent in the 15 mins I had with the patient

    Click to expand…

    Well, I’m not hatton but I will chime in.  I don’t think anyone expects you  to be very productive without a MA, but in your initial post you seemed kind of introspective and mentioned you were doubting yourself in addition to the other problems at your clinic.

    To give you my background I am a solo FP and employ one PA.  She sees about 20 pts a day always has at least one MA working with her, usually with access to more.  To do otherwise makes no sense since her productivity is also my productivity, and if she doesn’t have adequate help she will eventually get frustrated and leave.  The MA’s are responsible for the med list, rooming the pt, starting obvious labs and trying to get old records.  All pts are told to show up 15 minutes before the appt.

    So some of your your frustration is definitely warranted, but on the other hand some of what you mention is stuff that happens to everybody.  The patient you mentioned was not properly scheduled – why would a new train wreck with 500 pages of records get 15 minutes?  All new pts seeing my PA get 30 minutes (except for simple acute problems), and the receptionists have the authority to schedule 45 minutes if they think it’s really complicated. But sometimes sh*t happens, the patient tells the receptionist one thing and tells you a different thing.  To me the thing to do would be to handle the patient’s acute problem then tell them to make a separate appt so you can do a more complete evaluation.   Reading your initial post though you came across as kind of overwhelmed by the situation – it actually sounds like you handled things pretty well.

    Anyway good luck and hang in there.

    #180747 Reply
    Liked by hatton1
    Avatar mainah 
    Participant
    Status: Advanced Practice Provider
    Posts: 40
    Joined: 10/04/2018

    Good information Rando, thanks for your input!

    #181389 Reply

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