Re: abdominal pain in the pcp office

[Guest guest]

abdominal pain is not a sore throat .It is insane to see abdominal pain in 15 minutes.I don't have to remind u about how many organs andSystems are enclosed inside the abdominal cavity .IMHO u need a good medical history and pe plusAny tests that u may have to help u.It seems that u are working with administrators fromAn assembly line or a butcher shop.Remember at the end of the day is ur lic on the line.They will wash their hands and let u burn in court.Anyway my 1/2 cent.Adolfo E. Teran, MD

I was curious to get some group feedback on a tricky subject.I am now working for a group called zoom care with clinics in Portland OR and Seattle. Its an interesting group trying to bring a new perspective to primary care.In the past, management had considered abdominal pain a 30 min visit. But it was changed several months ago to 15 minutes. Its been met with some backlash, particularly when trying to see a female patient with abdominal pain in 15 minutes--between a pelvic exam and checking a UA and often a Urine pregnancy test, it can really put a provider behind in the schedule.I'm currently working with the rest of management to figure out is there a compromise or a way to get back to the 30 min visit template, at least for female patients.Of course, the initial concern I get is the loss of revenue--not just seeing potentially half of the abdominal pain patients in a week/day/month system wide, but also all the other patients that can't be seen because a female abdominal pain would take up two -15 min appointments.It does certainly seem to underscore how reliant and or beholden primary care is just to volume of visits let alone complexity.So I'm just crunch some numbers but if anyone had any insight in how they handle this in their own practice, Including how long you spend with an abdominal pain patient (30 min visit, 15? 20 ?) I would be curious to hear about it…We also have the typical pressures to not make any mistakes, to not have any angry patients that are going to complain, etc etc,, and obviously we don't want a patient to have a bad outcome or miss a potentially serious diagnosis…-- Sent with Sparrow

=

[Guest guest]

Adolfo I completely agree with you!I think 30 min is appropriate…I am just trying to crunch some numbers and I do think its important to factor in staff satisfaction i.e. loss of staff/providers over this and how much that would cost in terms of lost revenue, time to retrain and re-hire new staff, etc etc. But how much I am not sure yet..With a 30 min slot we are more likely to get a Urine test, a urine pregnancy test and maybe h pylori, so we get back some revenue from in house testing moreso than if it was a 15 min visit…which does help somewhat…so I will factor that in also.But I agree. Its not just the history and physical, but often getting an ultrasound or imaging is another burden and with 15 minutes, its tough to call for a pre-authorization, and if you think the patient is that sick to get a stat ct scan for instance….then..should you just send them to the ER anyway?It would certainly be nice if time was not such an important consideration----for me I am truly sick of the "see the patient, see them on time, see them fast so you can see another patient and have high volume of visits, but never have any complaints, and no mistakes…" mindset…which I guess most hospital based practices or larger groups do tend to push on their employees!

-- Sent with Sparrow

abdominal pain is not a sore throat .It is insane to see abdominal pain in 15 minutes.I don't have to remind u about how many organs andSystems are enclosed inside the abdominal cavity .IMHO u need a good medical history and pe plusAny tests that u may have to help u.It seems that u are working with administrators fromAn assembly line or a butcher shop.Remember at the end of the day is ur lic on the line.They will wash their hands and let u burn in court.Anyway my 1/2 cent.Adolfo E. Teran, MD

I was curious to get some group feedback on a tricky subject.I am now working for a group called zoom care with clinics in Portland OR and Seattle. Its an interesting group trying to bring a new perspective to primary care.In the past, management had considered abdominal pain a 30 min visit. But it was changed several months ago to 15 minutes. Its been met with some backlash, particularly when trying to see a female patient with abdominal pain in 15 minutes--between a pelvic exam and checking a UA and often a Urine pregnancy test, it can really put a provider behind in the schedule.I'm currently working with the rest of management to figure out is there a compromise or a way to get back to the 30 min visit template, at least for female patients.Of course, the initial concern I get is the loss of revenue--not just seeing potentially half of the abdominal pain patients in a week/day/month system wide, but also all the other patients that can't be seen because a female abdominal pain would take up two -15 min appointments.It does certainly seem to underscore how reliant and or beholden primary care is just to volume of visits let alone complexity.So I'm just crunch some numbers but if anyone had any insight in how they handle this in their own practice, Including how long you spend with an abdominal pain patient (30 min visit, 15? 20 ?) I would be curious to hear about it…We also have the typical pressures to not make any mistakes, to not have any angry patients that are going to complain, etc etc,, and obviously we don't want a patient to have a bad outcome or miss a potentially serious diagnosis…-- Sent with Sparrow

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[Guest guest]

Zoom Care managers may want to consider the Minute Clinic concept of limiting the CCs that they will evaluate- perhaps send abdominal pain somewhere else. The name, Zoom Care, sounds like a Minute Clinic type service rather than a truly integrated primary care service. They cannot be everything to everyone. I agree with Adolfo's post- you are ultimately responsible for the standard of care you deliver - its not worth the risk liability-wise or in regard to your ethical responsibility to the patient. Maybe if you were in a combat zone, it would a different story but it does seem insane to give an abdominal pain complaint the same time slot as pink eye. Carla Gibson To: Sent: Wednesday, July 4, 2012 11:58 AM Subject: abdominal pain in the pcp office

I was curious to get some group feedback on a tricky subject.I am now working for a group called zoom care with clinics in Portland OR and Seattle. Its an interesting group trying to bring a new perspective to primary care.In the past, management had considered abdominal pain a 30 min visit. But it was changed several months ago to 15 minutes. Its been met with some backlash, particularly when trying to see a female patient with abdominal pain in 15 minutes--between a pelvic exam and checking a UA and often a Urine pregnancy test, it can really put a provider behind in the schedule.I'm currently working with the rest of management to figure out is there a compromise or a way to get back to the 30 min visit template, at least for female patients.Of course, the initial concern I

get is the loss of revenue--not just seeing potentially half of the abdominal pain patients in a week/day/month system wide, but also all the other patients that can't be seen because a female abdominal pain would take up two -15 min appointments.It does certainly seem to underscore how reliant and or beholden primary care is just to volume of visits let alone complexity.So I'm just crunch some numbers but if anyone had any insight in how they handle this in their own practice, Including how long you spend with an abdominal pain patient (30 min visit, 15? 20 ?) I would be curious to hear about it…We also have the typical pressures to not make any mistakes, to not have any angry patients that are going to complain, etc etc,, and obviously we don't want a patient to have a bad outcome or miss a potentially serious

diagnosis…-- Sent with Sparrow

[Guest guest]

Easy tell ur white collar butchers if they would sign a legal document where they are forcing u to see an abdominal pain patient in 15 minutes and if there is a malpractice against u because u missed or made a mistake they will be with u at court and their personal assets would be in the line.U r wasting ur time trying to gather numbers ,statistics to prove a common sense point that not even the er doctors see an abdominal pain in that time.Your butchers want u to see a patient every 5 minutes if they could force to.I know what to do, I got solution for u: abdominal pain= er referral no matter what.I see the patient touch their tommy and smile and tell them to go to the closest er.End of the story, u see ur patient in ur pink eye time slotAdolfo E. Teran,MD

Adolfo I completely agree with you!I think 30 min is appropriate…I am just trying to crunch some numbers and I do think its important to factor in staff satisfaction i.e. loss of staff/providers over this and how much that would cost in terms of lost revenue, time to retrain and re-hire new staff, etc etc. But how much I am not sure yet..With a 30 min slot we are more likely to get a Urine test, a urine pregnancy test and maybe h pylori, so we get back some revenue from in house testing moreso than if it was a 15 min visit…which does help somewhat…so I will factor that in also.But I agree. Its not just the history and physical, but often getting an ultrasound or imaging is another burden and with 15 minutes, its tough to call for a pre-authorization, and if you think the patient is that sick to get a stat ct scan for instance….then..should you just send them to the ER anyway?It would certainly be nice if time was not such an important consideration----for me I am truly sick of the "see the patient, see them on time, see them fast so you can see another patient and have high volume of visits, but never have any complaints, and no mistakes…" mindset…which I guess most hospital based practices or larger groups do tend to push on their employees!

-- Sent with Sparrow

abdominal pain is not a sore throat .It is insane to see abdominal pain in 15 minutes.I don't have to remind u about how many organs andSystems are enclosed inside the abdominal cavity .IMHO u need a good medical history and pe plusAny tests that u may have to help u.It seems that u are working with administrators fromAn assembly line or a butcher shop.Remember at the end of the day is ur lic on the line.They will wash their hands and let u burn in court.Anyway my 1/2 cent.Adolfo E. Teran, MD

I was curious to get some group feedback on a tricky subject.I am now working for a group called zoom care with clinics in Portland OR and Seattle. Its an interesting group trying to bring a new perspective to primary care.In the past, management had considered abdominal pain a 30 min visit. But it was changed several months ago to 15 minutes. Its been met with some backlash, particularly when trying to see a female patient with abdominal pain in 15 minutes--between a pelvic exam and checking a UA and often a Urine pregnancy test, it can really put a provider behind in the schedule.I'm currently working with the rest of management to figure out is there a compromise or a way to get back to the 30 min visit template, at least for female patients.Of course, the initial concern I get is the loss of revenue--not just seeing potentially half of the abdominal pain patients in a week/day/month system wide, but also all the other patients that can't be seen because a female abdominal pain would take up two -15 min appointments.It does certainly seem to underscore how reliant and or beholden primary care is just to volume of visits let alone complexity.So I'm just crunch some numbers but if anyone had any insight in how they handle this in their own practice, Including how long you spend with an abdominal pain patient (30 min visit, 15? 20 ?) I would be curious to hear about it…We also have the typical pressures to not make any mistakes, to not have any angry patients that are going to complain, etc etc,, and obviously we don't want a patient to have a bad outcome or miss a potentially serious diagnosis…-- Sent with Sparrow

=

[Guest guest]

RE how much time per complaint.I have another question...how many exam rooms do you run at once? Maybe if you had more space you could see more pts?Yes I am certain that the issues involved here are more than that -- seeing pts in less time because "the overhead is too high" is a "slippery slope."M in Western PATo: Sent: Wednesday, July 4, 2012 3:26:05 PMSubject: Re: abdominal pain in the pcp office

Easy tell ur white collar butchers if they would sign a legal document where they are forcing u to see an abdominal pain patient in 15 minutes and if there is a malpractice against u because u missed or made a mistake they will be with u at court and their personal assets would be in the line.U r wasting ur time trying to gather numbers ,statistics to prove a common sense point that not even the er doctors see an abdominal pain in that time.Your butchers want u to see a patient every 5 minutes if they could force to.I know what to do, I got solution for u: abdominal pain= er referral no matter what.I see the patient touch their tommy and smile and tell them to go to the closest er.End of the story, u see ur patient in ur pink eye time slotAdolfo E. Teran,MD

Adolfo I completely agree with you!I think 30 min is appropriate…I am just trying to crunch some numbers and I do think its important to factor in staff satisfaction i.e. loss of staff/providers over this and how much that would cost in terms of lost revenue, time to retrain and re-hire new staff, etc etc. But how much I am not sure yet..With a 30 min slot we are more likely to get a Urine test, a urine pregnancy test and maybe h pylori, so we get back some revenue from in house testing moreso than if it was a 15 min visit…which does help somewhat…so I will factor that in also.But I agree. Its not just the history and physical, but often getting an ultrasound or imaging is another burden and with 15 minutes, its tough to call for a pre-authorization, and if you think the patient is that sick to get a stat ct scan for instance….then..should you just send them to the ER anyway?It would certainly be nice if time was not such an important consideration----for me I am truly sick of the "see the patient, see them on time, see them fast so you can see another patient and have high volume of visits, but never have any complaints, and no mistakes…" mindset…which I guess most hospital based practices or larger groups do tend to push on their employees!

-- Sent with Sparrow

abdominal pain is not a sore throat .It is insane to see abdominal pain in 15 minutes.I don't have to remind u about how many organs andSystems are enclosed inside the abdominal cavity .IMHO u need a good medical history and pe plusAny tests that u may have to help u.It seems that u are working with administrators fromAn assembly line or a butcher shop.Remember at the end of the day is ur lic on the line.They will wash their hands and let u burn in court.Anyway my 1/2 cent.Adolfo E. Teran, MD

I was curious to get some group feedback on a tricky subject.I am now working for a group called zoom care with clinics in Portland OR and Seattle. Its an interesting group trying to bring a new perspective to primary care.In the past, management had considered abdominal pain a 30 min visit. But it was changed several months ago to 15 minutes. Its been met with some backlash, particularly when trying to see a female patient with abdominal pain in 15 minutes--between a pelvic exam and checking a UA and often a Urine pregnancy test, it can really put a provider behind in the schedule.I'm currently working with the rest of management to figure out is there a compromise or a way to get back to the 30 min visit template, at least for female patients.Of course, the initial concern I get is the loss of revenue--not just seeing potentially half of the abdominal pain patients in a week/day/month system wide, but also all the other patients that can't be seen because a female abdominal pain would take up two -15 min appointments.It does certainly seem to underscore how reliant and or beholden primary care is just to volume of visits let alone complexity.So I'm just crunch some numbers but if anyone had any insight in how they handle this in their own practice, Including how long you spend with an abdominal pain patient (30 min visit, 15? 20 ?) I would be curious to hear about it…We also have the typical pressures to not make any mistakes, to not have any angry patients that are going to complain, etc etc,, and obviously we don't want a patient to have a bad outcome or miss a potentially serious diagnosis…-- Sent with Sparrow

=

[Guest guest]

I'd go with your gut on this one.

, I agree with everyone else.  But here is another example.  You know I work for accretive health, reviewing hospitalized cases.  We are felt to be superstars if we can do 2.5 cases in an hour, ie one every 15 minutes.  We have an abdominal pain protocol, and I still can't review the data and write up 2 paragraphs on an abdominal pain in 15 minutes, and I DIDN'T have to do the exam, order, wait on and review the labs, XR's etc.  This is a recipe for disaster.  And having worked for plenty of suits, they won't get it, no matter how many statistics you have, because their ass isn't in the game, they just see the money.

CCote

To:

Sent: Wednesday, July 4, 2012 3:55:43 PMSubject: Re: abdominal pain in the pcp office

 

RE how much time per complaint.

I have another question...how many exam rooms do you run at once?  Maybe if you had more space you could see more pts?

Yes I am certain that the issues involved here are more than that -- seeing pts in less time because " the overhead is too high " is a " slippery slope. "

M in Western PA

To:

Sent: Wednesday, July 4, 2012 3:26:05 PMSubject: Re: abdominal pain in the pcp office 

Easy tell ur white collar butchers if they would sign a legal document where they are forcing u to see an abdominal pain patient in 15 minutes and if there is a malpractice against u because u missed or made a mistake they will be with u at court and their personal assets would be in the line.

U r wasting ur time trying to gather numbers ,statistics to prove a common sense point that not even the er doctors see an abdominal pain in that time.

Your butchers want u to see a patient every 5 minutes if they could force to.

I know what to do, I got solution for u: abdominal pain= er referral no matter what.

I see the patient touch their tommy and smile and tell them to go to the closest er.

End of the story, u see ur patient in ur pink eye time slotAdolfo E. Teran,MD

 

Adolfo I completely agree with you!

I think 30 min is appropriate…I am just trying to crunch some numbers and I do think its important to factor in staff satisfaction i.e.  loss of staff/providers over this and how much that would cost in terms of lost revenue, time to retrain and re-hire new staff, etc etc.  But how much I am not sure yet..

With a 30 min slot we are more likely to get a Urine test, a urine pregnancy test and maybe h pylori, so we get back some revenue from in house testing moreso than if it was a 15 min visit…which does help somewhat…so I will factor that in also.

But I agree.  Its not just the history and physical, but often getting an ultrasound or imaging is another burden and with 15 minutes, its tough to call for a pre-authorization, and if you think the patient is that sick to get a stat ct scan for instance….then..should you just send them to the ER anyway?

It would certainly be nice if time was not such an important consideration----for me I am truly sick of the " see the patient, see them on time, see them fast so you can see another patient and have high volume of visits, but never have any complaints, and no mistakes… "  mindset…which I guess most hospital based practices or larger groups do tend to push on their employees!

-- 

Sent with Sparrow

 

abdominal pain is not a sore throat .

It is insane to see abdominal pain in 15 minutes.

I don't have to remind u about how many organs and

Systems are enclosed inside the abdominal cavity .

IMHO u need a good medical history and pe plus

Any tests that u may have to help u.

It seems that u are working with administrators from

An assembly line or a butcher shop.

Remember at the end of the day is ur lic on the line.

They will wash their hands and let u burn in court.

Anyway my 1/2 cent.Adolfo E. Teran, MD

 

I was curious to get some group feedback on a tricky subject.

I am now working for a group called zoom care with clinics in Portland OR and Seattle.    

Its an interesting group trying to bring a new perspective to primary care.

In the past, management had considered abdominal pain a 30 min visit.  But it was changed several months ago to 15 minutes.  Its been met with some backlash, particularly when trying to see a female patient with abdominal pain in 15 minutes--between a pelvic exam and checking a UA and often a Urine pregnancy test, it can really put a provider behind in the schedule.

I'm currently working with the rest of management to figure out is there a compromise or a way to get back to the 30 min visit template, at least for female patients.

Of course, the initial concern I get is the loss of revenue--not just seeing potentially half of the abdominal pain patients in a week/day/month system wide, but also all the other patients that can't be seen because a female abdominal pain would take up two -15 min  appointments.

It does certainly seem to underscore how reliant and or beholden primary care is just to volume of visits let alone complexity.

So I'm just crunch some numbers but if anyone had any insight in how they handle this in their own practice, Including how long you spend with an abdominal pain patient (30 min visit, 15? 20 ?)  I would be curious to hear about it…

We also have the typical pressures to not make any mistakes, to not have any angry patients that are going to complain, etc etc,, and obviously we don't want a patient to have a bad outcome or miss  a potentially serious diagnosis…

-- 

Sent with Sparrow

=

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

Zoomcare actually has low overhead, and limited exam space--so its not so much about getting people in and out fast....its more about keeping the schedule moving so patients don't wait long to be seen, can be seen quickly and move onto the next patient.  I guess that means the same thing!  

For more simple complaints, like UTI/URI, the model can work well.  We don't deal with most chronic care problems (at least not in 15 minutes) so as long as the complaints are basic--it works fine.

Of course if the complaint is not so obvious, or if its a more complicated complaint (abdominal pain), it can fall apart pretty quickly.    But same could be said for many Primary care practices.  Certainly at the old job if a completely new patient showed up with 50 pounds of old medical record, and symptoms that defied diagnosis, it was usually a disaster.  And hospital provided call center and staff were kind of helpless trying to get records ahead of time or scheduling it so it made any sense--so the first visit was usually a total waste of time.

It would seem by current calculations, which I take with a grain of salt, that there would be a loss of about $11,000 a month if the company went to 30 min visits from 15 min visits.  But, anyone want to guess how much one law suit would potentially cost?  If I can factor that in for comparison, that might get some attention!

I think the people involved in the company actually have good intentions--and I think the plan that was developed to streamline the visit was well thought out.  But it sort of depends on everything going smoothly--in reality patients give inconsistent history, they show up late, they want to leave early, they refuse to pay for tests you think they need, and then want to blame you for missing the diagnosis when they refused to get any tests or follow up as instructed.    Until this is factored more into the equation, there will always be conflict.

Now my prior job I thought was much, much worse about this....at least I am involved in the current making process.  In previous experience I would get lectured at from completely non-medical " efficiency " experts that would explain how you can get your work done faster and faster...and it was vastly more unrealistic.  My tipping point was being shadowed by an expert when another doctor was on vacation and another called in sick and I had to pick up the slack.  When every patient in the practice seemed to be calling in for early narc refills.  And then calling again. She was like " uh...lets do this another day.. " and I kind of felt that their experts really don't know what the work burden is on a primary care provider--or maybe don't want to know so they can figure out new ways to demand more productivity?

, there are certainly days I wonder what would have been if I just stuck with the job at Accretive instead of zoomcare....if I had kept to 20 hours a week, certainly I'd  have much more free time!  Perhaps enough to run a small practice on the side...but alas, I went in a different direction.  It seemed like a good idea at the time!  Not sure if I would be as stressed with just doing chart reviews all day! 

DBF

 

I'd go with your gut on this one.

, I agree with everyone else.  But here is another example.  You know I work for accretive health, reviewing hospitalized cases.  We are felt to be superstars if we can do 2.5 cases in an hour, ie one every 15 minutes.  We have an abdominal pain protocol, and I still can't review the data and write up 2 paragraphs on an abdominal pain in 15 minutes, and I DIDN'T have to do the exam, order, wait on and review the labs, XR's etc.  This is a recipe for disaster.  And having worked for plenty of suits, they won't get it, no matter how many statistics you have, because their ass isn't in the game, they just see the money.

CCote

To:

Sent: Wednesday, July 4, 2012 3:55:43 PMSubject: Re: abdominal pain in the pcp office

 

RE how much time per complaint.

I have another question...how many exam rooms do you run at once?  Maybe if you had more space you could see more pts?

Yes I am certain that the issues involved here are more than that -- seeing pts in less time because " the overhead is too high " is a " slippery slope. "

M in Western PA

To:

Sent: Wednesday, July 4, 2012 3:26:05 PMSubject: Re: abdominal pain in the pcp office 

Easy tell ur white collar butchers if they would sign a legal document where they are forcing u to see an abdominal pain patient in 15 minutes and if there is a malpractice against u because u missed or made a mistake they will be with u at court and their personal assets would be in the line.

U r wasting ur time trying to gather numbers ,statistics to prove a common sense point that not even the er doctors see an abdominal pain in that time.

Your butchers want u to see a patient every 5 minutes if they could force to.

I know what to do, I got solution for u: abdominal pain= er referral no matter what.

I see the patient touch their tommy and smile and tell them to go to the closest er.

End of the story, u see ur patient in ur pink eye time slotAdolfo E. Teran,MD

 

Adolfo I completely agree with you!

I think 30 min is appropriate…I am just trying to crunch some numbers and I do think its important to factor in staff satisfaction i.e.  loss of staff/providers over this and how much that would cost in terms of lost revenue, time to retrain and re-hire new staff, etc etc.  But how much I am not sure yet..

With a 30 min slot we are more likely to get a Urine test, a urine pregnancy test and maybe h pylori, so we get back some revenue from in house testing moreso than if it was a 15 min visit…which does help somewhat…so I will factor that in also.

But I agree.  Its not just the history and physical, but often getting an ultrasound or imaging is another burden and with 15 minutes, its tough to call for a pre-authorization, and if you think the patient is that sick to get a stat ct scan for instance….then..should you just send them to the ER anyway?

It would certainly be nice if time was not such an important consideration----for me I am truly sick of the " see the patient, see them on time, see them fast so you can see another patient and have high volume of visits, but never have any complaints, and no mistakes… "  mindset…which I guess most hospital based practices or larger groups do tend to push on their employees!

-- 

Sent with Sparrow

 

abdominal pain is not a sore throat .

It is insane to see abdominal pain in 15 minutes.

I don't have to remind u about how many organs and

Systems are enclosed inside the abdominal cavity .

IMHO u need a good medical history and pe plus

Any tests that u may have to help u.

It seems that u are working with administrators from

An assembly line or a butcher shop.

Remember at the end of the day is ur lic on the line.

They will wash their hands and let u burn in court.

Anyway my 1/2 cent.Adolfo E. Teran, MD

 

I was curious to get some group feedback on a tricky subject.

I am now working for a group called zoom care with clinics in Portland OR and Seattle.    

Its an interesting group trying to bring a new perspective to primary care.

In the past, management had considered abdominal pain a 30 min visit.  But it was changed several months ago to 15 minutes.  Its been met with some backlash, particularly when trying to see a female patient with abdominal pain in 15 minutes--between a pelvic exam and checking a UA and often a Urine pregnancy test, it can really put a provider behind in the schedule.

I'm currently working with the rest of management to figure out is there a compromise or a way to get back to the 30 min visit template, at least for female patients.

Of course, the initial concern I get is the loss of revenue--not just seeing potentially half of the abdominal pain patients in a week/day/month system wide, but also all the other patients that can't be seen because a female abdominal pain would take up two -15 min  appointments.

It does certainly seem to underscore how reliant and or beholden primary care is just to volume of visits let alone complexity.

So I'm just crunch some numbers but if anyone had any insight in how they handle this in their own practice, Including how long you spend with an abdominal pain patient (30 min visit, 15? 20 ?)  I would be curious to hear about it…

We also have the typical pressures to not make any mistakes, to not have any angry patients that are going to complain, etc etc,, and obviously we don't want a patient to have a bad outcome or miss  a potentially serious diagnosis…

-- 

Sent with Sparrow

=

-- Graham Chiuhttp://www.compkarori.co.nz:8090/Synapse - the use from anywhere EMR.

[Guest guest]

Adolfo - what ER to go to if uninsured?

>

> > their ass isn't in the game, they just see the money.

>

[Guest guest]

Curious stuff I am not sure I get the business model Zoom care has. I f it is urgent care , people wait to be seen til you are ready to see them yes?Sorry if you explained it... If it is like an office the slots would be based on something like 15 or 20min  slots  that you could  put > 1 slot together IF you knew what the pateitn was coming in for, say a physical?  So are these folks calling ahead?

Who decides this time thing? It is decided by someone before the patietn shows up OR the patietn gets there and someone allots you time by which you must be done?Time is  a real stressor I am sitting here talking to anohter IMP about this  and I can only manage it really well maybe 70% of the time becasue patietns  like to yak, becasue I cannot get up and leave I am an IMP in one room, becasue of money Money is a problem:)But mostly  there ought ot be a way to figure this outHmm

 

Adolfo - what ER to go to if uninsured?

>

> > their ass isn't in the game, they just see the money.

>

--      MD          ph    fax

[Guest guest]

Closest ER is typically required to treat emergencies, regardless of insurance.  I don't think most hospitals in most states would turn away someone with a life-threatening symptom until they know that it is for sure not life-threatening.  In CA, they don't usually even ask for insurance info until after you've had an initial P & E done.

Pratt

 

Adolfo - what ER to go to if uninsured?

>

> > their ass isn't in the game, they just see the money.

>