Re: Gyn: mammography in new patients

From: Anna Meenan, MD (annam@uic.edu)
Sat Jan 7 00:12:56 2006

I agree with the new partner too, and find it sad that things have come to this, but the reality is that they have. All it would take would be for one abnormal report to slip through the cracks somehow (which is more likely to happen if there is no chart to file it in when it arrives at the clinic) and your practice could be ruined. It's another one of those things we just can't offer patients anymore because of the malpractice situation, and I would just have your staff tell the patients when they call that you cannot order tests until you have seen the patient. I would never expect a doctor I hadn't seen yet to order tests for me. You take on responsibility and risk, you take the time to track down and notify the patient and arrange followup, and you haven't been paid yet. 

--
Anna Meenan, MD


At Fri,  6 Jan 2006, Garry E. Siegel, M.D. wrote:
>
>My partner, new associate and I had a long, tedious discussion about the
>following, and I would welcome input on or off list.
>
>For years, my partner and I/our practice has taken calls from new
>patients who get a "New Annual Examination" appointment, and ask to set
>up a screening mammogram, too.  The mammogram is done elsewhere,
>requires a written requisition from our office, and may be done (the
>patient schedules it herself) BEFORE one of us ever sees her.  We get
>the report, and the patient, in theory, is informed of the result
>directly by the mammography unit.  The report is reviewed by the
>ordering MD (i.e.  the one with whom she has an appointment)and filed to
>be retrieved and placed in her chart on her actual arrival.
>
>If the result is ABNORMAL, we contact the patient via the information we
>have, and if we can't find her, we get the demographics from the
>mammogram unit and call/write her.
>
>The frequency of new patients calling to set up both appointments is not
>low; the frequency of an abnormal report in a new patient whom we can't
>contact is very, very rare.
>
>The new associate does not like this at all because:
>1.  No physician patient contract exists.
>2.  We are assuming care (read liability)for a test prior to examining
>her.
>
>My partner and I think:
>1.  From a global perspective, we want to do anything possible to
>increase the frequency of mammography where appropriate.
>2.  It is good customer service.
>3.  It captures business, i.e.  if we refuse to set up the mammo BEFORE
>the appointment, it is plausible that the patient might simply say "no
>thanks" to everything and call the Ob/Gyn down the street, Robert
>Modugno.
>4.  The liability potential is tiny because we're "doing the right
>thing" and our intentions are good.
>
>What say you?
>
>--
>Garry E. Siegel, M.D.
>Private Practice
>Roswell, GA
>



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