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Re: Newly pregnant existing patients From: Garry E. Siegel, M.D. (garrys@mindspring.com) Wed Feb 26 11:13:12 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Garry E. Siegel, M.D.: "Re: Newly pregnant existing patients" Previous message: Lynn D. Montgomery, M.D.: "Re: Newly pregnant existing patients" In reply to: D. Ashley Hill, MD: "Re: Newly pregnant existing patients" We've tried the nurse visit stuff ASAP, and this never seemed to work out--time out from work, etc. Your concern is a valid one, and we rely on the patients having been educated about ectopic risk with old PID, etc. Garry At Tue, 25 Feb 2003, D. Ashley Hill, MD wrote: > >At Tue, 25 Feb 2003, Garry E. Siegel, M.D. wrote: >snip >>I am trying to continue with relationship based care (thanks, Deborah), >>and simply hearing that "so and so" is pregnant seems to be a good >>idea--for instance, if "so and so" calls at night 4 days after she made >>her first appointment, you can impress her that you knew she was >>pregnant! >> >>Garry > >Garry- > >There is another potential issue. Let's say you have a patient in your >practice with a history of pelvic inflammatory disease, a prior ruptured >appendix, and has had 3 prior ectopic pregancies (all treated with MTX >or linear salpingostomy) who calls for an appointment. You're a popular >dude, so it's scheduled 2-3 weeks from now. In the meantime, she gets >abdominal pain and presents to the emergency department with a ruptured >ectopic requiring surgery and two units of blood. I can see a lawyer >blaming you because you did not call to warn her that she is at risk for >an ectopic, and make arrangements for serial HCG determinations and >sonography. > >In our 6-doctor practice a nurse sees all OB patients as soon as >possible after they call. She interviews them, signs the paperwork, >begins filling out the ACOG form, and obtains old records and labs. A >doctor then reviews the chart, and, if necessary, requests more >information or arranges appropriate follow-up. It works extremely well. >Best wishes, > >Ashley > >-- >D. Ashley Hill, MD >Associate Director >Department of Obstetrics and Gynecology >Florida Hospital Family Practice Residency >Orlando, Florida > -- Garry E. Siegel, M.D. Private Practice Roswell, GA Next message: Garry E. Siegel, M.D.: "Re: Newly pregnant existing patients" Previous message: Lynn D. Montgomery, M.D.: "Re: Newly pregnant existing patients" In reply to: D. Ashley Hill, MD: "Re: Newly pregnant existing patients"

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