Re: Family Practice Consultation Guidelines
From: Garry E. Siegel, M.D. (garrys@mindspring.com)
Wed May 7 19:49:02 2003
At our small hospital, the issue of FPs doing Ob has resurfaced. There
has not been an FP doing Ob here in over 14 years, but there may be one
coming. Our chair has proposed that we amend the FP's delineation of
privileges such that they have prearragned for Ob backup (as opposed to
the Ob on call) or they can't do any Ob.
I suggested that a conversation needed to take place between the two
chairmen BEFORE the OB department changed the FP privileges. I think
the two departments will agree on this issue, but perhaps not how it is
being handled.
I felt that we did not have the domain to change another department's
privileges--PERIOD--just as they can't alter ours. Granted, due to
unique nature of the potential relationship, we must have input. . .
Garry
At Wed, 7 May 2003, Anna Meenan, MD wrote:
>
>Yes, we do credential ourselves, just as every other department in the
>hospital credentials themselves. None of the other departments attempts
>to dictate to us when we should consult them, and we don't dictate to,
>for instance, surgeons (or obstetricians either), when they ought to be
>required to get an internal medicine or family practice consult. Our
>department created such a list and did run it by the OB's, and so far it
>is working well. Can't lay my hands on it at the moment but I will see
>if I can find a copy.
>
>--
> Anna Meenan, MD, FAAFP
>
>At Wed, 7 May 2003, Braun, R. Daniel wrote:
>>
>>Good Luck.
>>Been there, Done that. No success. Once they have the right to
>>credential themselves, you're out of it.
>>Dan
>>-----Original Message-----
>>From: Lynn D. Montgomery, M.D. [mailto:apgar10@montanadsl.net]
>>Sent: Tuesday, May 06, 2003 2:37 PM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: Family Practice Consultation Guidelines
>>
>>Dan,
>>I agree completely; there are two issues, 1) those currently practicing
>>have privileges and you can't change the privileges unless they want
>>them changed, 2)They have their own family practice section, as many
>>hospital do, who oversee ALL of their privileges and the OB section is
>>powerless to mandate anything, again unless they agree.
>>
>>That said, there are members of the OB section that have the attitude
>>that "By God, I am an obstetrician and if I say they need to consult,
>>that's final". On the other side of the coin, there are family
>>practitioners who are saying, "You don't credential us, we credential
>>ourselves and we'll decide when a consult is required".
>>
>>Since The sections and bylaws are well established, neither side is
>>gonna back down - unless of course there is a consensus reached. That
>>is the impetus for my request for other's guidelines - I am sitting down
>>with a representative from the family practice section to see if we can
>>come to a mutually acceptable set of guidelines.
>>Lynn
>>
>>--
>>Lynn D. Montgomery, M.D.
>>Rocky Mountain Women's Health
>>2835 Fort Missoula Rd., Suite 303
>>Missoula, Montana, 59804
>>406-549-0978
>>fax 406-549-0987
>>e-mail: apgar10@montanadsl.net
>> -----Original Message-----
>> From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf
>>Of Braun, R. Daniel
>> Sent: Tuesday, May 06, 2003 11:39 AM
>> To: Multiple recipients of list OB-GYN-L
>> Subject: RE: Family Practice Consultation Guidelines
>> The short answer to that is anytime he/she does not have
>>privileges to do what they want to do. The best thing is to have a good
>>definition of what their privileges are and then enforce that.
>>
>> Dan
>>
>> -----Original Message-----
>> From: Lynn D. Montgomery, M.D. [mailto:apgar10@montanadsl.net]
>> Sent: Tuesday, May 06, 2003 11:27 AM
>> To: Multiple recipients of list OB-GYN-L
>> Subject: Family Practice Consultation Guidelines
>>
>> Happy Tuesday y'all,
>>
>> If anybody has guidelines in their hospital policies regarding
>>when a family practitioner must consult an obstetrician regarding
>>obstetric management, would you be so kind as to send a copy of them to
>>my e-mail, off list. Thanks a bunch.
>> Lynn
>>
>> Lynn D. Montgomery, M.D.
>> Rocky Mountain Women's Health
>> 2835 Fort Missoula Rd., Suite 303
>> Missoula, Montana, 59804
>> 406-549-0978
>> fax 406-549-0987
>> e-mail: apgar10@montanadsl.net
>>
--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA
