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Re: mammography in new patientsFrom: ainsron (ainsron@sbcglobal.net)Mon Jan 9 10:41:24 2006
I don't order tests on patients I don't have an ongoing relationship with. Waiting to order the mammogram until after the patient has been seen and a chart prepared seems like the best way for me. Ronald E. Ainsworth, MD, FACOG -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Garry E. Siegel, M.D. Sent: Friday, January 06, 2006 7:34 PM To: Multiple recipients of list OB-GYN-L Subject: Gyn: mammography in new patients 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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