Thursday, February 14, 2008

Would you like whine with that?

I pity the poor medical students who do clinical rotations with me. They have to listen to me complaining non-stop.

They're always polite and attentive about my griping. I hope they don't think their rotation assessment could be affected by the quality of their sympathetic nodding.

When a student is in the office with me, my main topic to moan about is inadequate information in the referral letters I receive. I've blogged about this before. Anyway, a senior medical student just spent a few days with me in the office, and yesterday, I was in mid-kvetch when I thought "I gotta stop whining about this and actually do something about it."

We've had success with sending out a checklist to referring doctors regarding a specific condition (microscopic hematuria). We ask for certain information and test results to be sent along to us, before we see the patient. You can see the letter on our office website.

I'm thinking of a different approach for information on a person's past medical history, medications and allergies. I'll try sending out a questionnaire directly to the patient. After all, it's the same questions they'll answer when they come to see me anyway.

This isn't earth-shattering, I know. It's already done in many offices, whether ahead of time, or as something to be completed when the patient arrives at the office. I'm sure there will be lots of forms and templates I can steal (I mean, collaborate non-consensually). I'm thinking I'll send out 10 trial forms with the patient's appointment letter and ask them to either mail the form back or fax it to me. I'll keep track of who had the forms sent to them and how many are returned.

I'll let you know how it goes.

1 comment:

Joe Black said...

This has unfortunately been tried before - some Specialist groups send letters to patients requesting a medication list, history and allergies.

The majority of elderly patients merely take this form to the Family physician, requesting a medication list and ask "the doctor can just take two minutes to fill this form out".

This is not an insurable service according to the MCIB rules. The patient will have to be charged for this, but they do not know that.

This leads to another wasted appointment and frustration at being charged, for what they believe being an essential service.

The paper generated is also phenomenal - you are leaving a very large ecological footprint in exchange for information that should be readily avaiable.To quote the X-files: "The truth is out there"

If I can make a suggestion - start at the origin of the referral. E-mail a document or template to your referring physicians, and make it so that it can be filled out on the electronic record, or directly in a WORD document. Otherwise it has to be printed and then filled out, photocopied and filed (again)

Make the document as simple or as thorough as you want it to be eg: List the allergies, previous diseases, medication, surgical history and reason for the requested consult.

And.. since you have the Medical student - have him or her access the PIP (Pharmaceutical Information Program) viewer, and view the list of medications. This will also give the student some exposure to the future of E-prescribing.

Just a suggestion from the trenches....