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GYN: New patients--to examine, or not to examineFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Sun Aug 3 08:49:20 2003
A few times a year, either our CNM or I will see a new patient who comes in from another practice, or more likely another city, to discuss either hormones/perimenopasuse (40's and 50's), or their OCPs (20's). Many times, they have had their annual exam and pap within a few months, and really aren't "due" for another exam and/or pap. Sometimes, they'll have the records, but often not. At times, the patients will pretty much ask, "do I really have to have an exam again, or why do you need to examine me?" The real issue of the visit is to discuss/alter/stop/start medicines/hormones. I sometimes will choose to not examine these patients, and to only renew/prescribe meds until 12 months from their last exam elsewhere. I have tended to ask our CNM to virtually always examine these people, as I feel that she should err on the side of doing "too much," and if something is to be omitted (like an examination), that those times should be few and far between. In today's world, you don't want to upset/offend your new patients, nor spend extra time/health care dollars unnecessarily, but you also want to be thorough, etc., and keep those tushies covered. What do you guys (mid-level input welcome) think? Should our practice: 1. Pretty much require an examination for all new patients? 2. Allow the CNM the same flexibility as the MD? 3. Take it on a case by case basis? If so, should the CNM have the same discretion as the MD? 4. Other? Garry
-- Garry E. Siegel, M.D. Private Practice Roswell, GA
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