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Re: GYN: New patients--to examine, or not to examine From: Efrain Ramirez (eramirezt@coqui.net) Sun Aug 3 15:31:04 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Efrain Ramirez: "Re: GYN: Osteoporosis/Osteopenia in pre-menopausal women" Previous message: DoctorJoe@aol.com: "Re: GYN: Osteoporosis/Osteopenia in pre-menopausal women" In reply to: Garry E. Siegel, M.D.: "GYN: New patients--to examine, or not to examine" I examine my patients on yearly basis - and BTW - have you read the new ACOG's guidelines on Pap Smears - I am a little confuse - what's the end point - I thought there were to many -- "subroutines"?? > At Sun, 3 Aug 2003, Garry E. Siegel, M.D. wrote: > >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 > -- "The opposite of a correct statement is a false statement. But the opposite of a profound truth may well be another profound truth." Niels Bohr (1885 - 1962) Next message: Efrain Ramirez: "Re: GYN: Osteoporosis/Osteopenia in pre-menopausal women" Previous message: DoctorJoe@aol.com: "Re: GYN: Osteoporosis/Osteopenia in pre-menopausal women" In reply to: Garry E. Siegel, M.D.: "GYN: New patients--to examine, or not to examine"

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