Re: Admitting labs, wasTocolytics
From: Dr. Ainsworth (ainsron@sbcglobal.net)
Thu Jun 16 01:23:51 2005
Their responsibilities are different. At least in California, the
medical staff is responsible for developing and enforcing their own
bylaws, rules and regulations. The Hospital Board has the authority to
approve or reject them, but they cannot write them and the medical staff
is responsible for committee functions that the hospital depends on for
meeting JCAHO requirements. We have an independent, but symbiotic
relationship that depends on good-will, not coersion for long-term
success.
At Wed, 15 Jun 2005, Efrain Ramirez wrote:
>
>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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