Re: Admitting labs, wasTocolytics
From: Efrain Ramirez (eramirezt@coqui.net)
Wed Jun 15 18:22:18 2005
Ron - to what extent is the medical staff independent from the
"hospital" – who is ultimately – legally responsible? I am in a
Community Hospital governed by a Board of Trustees - I am one of them
since a few years ago - been Head of department - I think there is fine
line .. IMHO -
> At Wed, 15 Jun 2005, ainsron wrote:
>
>The "hospital" cannot require anything of you. The medical staff (which is
>self-governing) may set specific requirements in its rules and regulations,
>or the department may place requirements on physicians. Most physicians
>probably do it because they have "always done it that way."
>
>Ronald E. Ainsworth, MD, FACOG
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Elrod
>Darryl G MAJ 48 MDOS/SGOBO
>Sent: Wednesday, June 15, 2005 12:28 AM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Admitting labs, wasTocolytics
>
>The hospital requires it?
>
>I've heard WIC requires it but a hospital. Does the hospital order the
>transfusion if its too low????
>
>Glen
>
>-----Original Message-----
>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Anna
>Meenan, MD
>Sent: Tuesday, June 14, 2005 3:05 PM
>To: Multiple recipients of list OB-GYN-L
>Subject: Re: Admitting labs, wasTocolytics
>
>Our hospital still requires routine cbc next day. I remember back
>pre-1983 when we used to transfuse anyone with hgb<10. Now I only
>transfuse them if they pass out when the nurse gets them up out of bed.
>Then, I don't need a cbc to tell me she's low.
>
>Anna Meenan, MD
>
>At Tue, 14 Jun 2005, Elrod Darryl G MAJ 48 MDOS/SGOBO wrote:
>>
>>So it's the 'spend more money to get more money' sort of mentality. I
>>don't buy it.
>>
>>I rounded on my 'elective' c/s this morning and didn't even look at the
>>CBC. She was up in the chair, eating, minimal bleeding, etc etc. Why
>>did I even order it in the first place??? Certainly not so the hospital
>>can make more money!
>>
>>Glen
>>
>>-----Original Message-----
>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>Joanne
>>Bulley, MD
>>Sent: Tuesday, June 14, 2005 2:38 AM
>>To: Multiple recipients of list OB-GYN-L
>>Subject: Re: Admitting labs, wasTocolytics
>>
>>I agree with you ... but some of the hospitals that have mostly
>>medicaid want / need the highest possible DRG find they get paid more
>if
>>they have the H/H showing the degree of drop in H/H ... So there are
>>definitely places where the lab test is ordered just for the fact that
>>it will increase reimbursements on some patients ...
>>
>>Joanne
>>
>>At Mon, 13 Jun 2005, Elrod Darryl G MAJ 48 MDOS/SGOBO wrote:
>>>
>>>I go with the flow and order a new CBC on admission. What I refuse to
>>>do is order a 'routine' postpartum CBC on vaginal deliveries. What a
>>>waste of time and money. They are ALL anemic and if they have any
>>>significant bleeding that requires treatment, you'll recognize it and
>>>then order a CBC.
>>>
>>>Glen
>>>
>>>-----Original Message-----
>>>From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of
>>Joanne
>>>Bulley, MD
>>>Sent: Sunday, June 12, 2005 2:04 AM
>>>To: Multiple recipients of list OB-GYN-L
>>>Subject: Re: Admitting labs, wasTocolytics
>>>
>>>They hospital may get paid more (a higher DRG) IF there is a drop in
>>the
>>>HGB pre and post partum ... other than that I don't think you need to
>>>do them again. It would not likely alter care anyway - and I do
>>believe
>>>in not ordering a lab test unless it is part of your decision making
>>for
>>>the current level of care.
>>>
>>>Joanne
>>>
>>>At Sat, 11 Jun 2005, RModugno@aol.com wrote:
>>>>
>>>>In a message dated 6/11/2005 4:59:48 PM Eastern Standard Time,
>>>igold@cox.net
>>>>writes:
>>>>
>>>>OK, so this is a good question. Earlier in the week, I'm admitting
>my
>>>first
>>>>patient since bieng credentialed. The nurse asks me which labs I
>>want,
>>>CBC,
>>>>type and screen? I look at the chart and see that the patients labs
>>>were done
>>>>in the lab at this hospital, so it would seem repeating the type
>>>uneccessary.
>>>>Last Hgb 11.6 at 36 weeks, hospital lab. What would I do with a new
>>>result
>>>>anyway, other than shrug. So what do you all do, recommend? (I told
>>>her to
>>>>defer labs)
>>>>
>>>>Ingrid Gold, CNM
>>>>Phoenix
>>>>
>>>>In our hospital - anesthesia will NOT place an epidural if they do
>not
>>>have
>>>>a current platelet count. We therefore do a Heme 8 and also an
>>>rpr(trird
>>>>trimester reqd by state law if not already done)
>>>>
>>>>Robert Modugno MD MBA FACOG
>>>>Marietta, Ga
>>>
>>>--
>>>Joanne Bulley, MD
>>>Keene, NH, USA
>>>
>>--
>>Joanne Bulley, MD
>>Keene, NH, USA
>>
--
I think I will do nothing for a long time but listen,
And accrue what I hear into myself...and let sounds
contribute toward me.
~walt whitman~
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