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Re: New HCFA RulingFrom: D. Ashley Hill, MD (dahmd@cfl.rr.com)Fri Sep 15 18:58:29 2000
At Fri, 15 Sep 2000, maggiecnm wrote:
>> One of my midwifery classmates actually lost her clinical site over this ruling last year (in PA) because the docsa and CNMs precepting her did not want to have to repeat everything on the patients (ie 2 pelvics, etc). She ended up having to wait an additional 6 months to finish her program and take boards because of this! I have mixed feelings about this. I certainly disagree with forcing attending physicians to do physical exam documentation themselves, as they may be responsbible for a number of students. It could take hours to see a few patients if the attending had to hand write or dictate an entire physical exam on each patient seen by students during rounds. On the other hand, pelvic exams (and some other physical exam skills) are often hard to master, so I would not usually be comfortable signing off on a student's pelvic exam. Since I teach Family Practice residents, some of whom have not had a lot of gyn experience, I frequently perform a pelvic exam either right before or after the resident performs one. If explained correctly, very few patients complain. Sounds like your classmate either had a lame preceptor or a particularly vocal patient population. Thanks, Ashley D. Ashley Hill, MD Orlando, FL
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