"Clinic call???" Is this normal?

[Gordon, PA-C]

I don't mean to be blunt, but it appears that you are not up to speed on the practice environment at least in my state, Massachusetts. May well be different in different states.

 

 

I cannot disagree with the sentiment that you are bringing up, I give away far too much knowledge at far too late in the night, but please do not confuse the sentiment with a what is the medicolegal environment that I practice in in Massachusetts. 

 

I would have never known there was such issues until I started my own practice. Now I start to see the light at how over regulated and under compensated And underappreciated primary care is.

 

 

 

 A simple question, do you practice in primary care?( see below) How long have you been up PA? Have you reviewed credentialing contracts? have you reviewed practice credentialing contracts with the local hospital?  It appears as though you work in a specialty--> pediatric Surgery, I therefore take your answers with a grain of salt. I would not ask the pediatric surgeon how to manage dementia, nor would I ask the pediatric surgery PA about primary care call issues.  However I would ask you quickly how to manage a surgical pediatric issue. We all have to understand we are experts in their own area, but that does not make us experts in every area.

 

1.  Please cite a link to your Massachusetts medical board ruling.  The link you provided doesnt work.

 

2.  I have worked in 8 different states, and I handled the PA credentialing for both insurance and hospital networks for myself and the other PAs; plus I got to see the MD contracts as well.  In NONE of those insurance contracts did it require 24/7 call availability and in NONE of the hospital credentialing applications did it require 24/7 call availability.  Massachusetts must be an outlier.

 

3.  Although the volume of phone calls to a pediatric surgery group is not as high as primary care, we still get calls in the middle of the night from patients, and we do NOT answer those calls or have them forwarded to any provider.  We simply have a standard recording that gives the typical "if this is an emergency call 911" stuff.  The only calls we answer are from hospital-based physicians or clinic providers who want a consult or want us to evaluate someone in the ED.

 

4.  In the 8 states I have worked in, I know multiple docs in those states who 1) practice primary care; 2) don't have hospital privileges; and 3) don't answer patient calls at night.  Again, your state Massachusetts seems to be an outlier.  

 

It appears that you work in the most ridiculously over-regulated state in the country.  Good luck to you sir.

[UpRegulated]

wow

 

what about the reality that medicine is a 24x7 profession?

 

Of course it is, but many professions are.  Tell me what professions do it without being reimbursed for it?  24/7/365 medical need is precisely why the EMS, ER's and urgent care clinics exist - for things that can't wait until tomorrow.  If it is something that truly cannot wait until tomorrow, then the patient needs to go to urgent care or the ER.  If it can wait until tomorrow, then the patient can call during office hours.  I don't know why this is a matter of dispute.  Why, precisely, is the primary care provider obligated to figure out what is urgent or not for zero reimbursement?  Do you expect your mechanic to answer his phone at 0300 when your car breaks down for FREE (which could be quite urgent)?  Do you expect your plumber to answer the phone at 0300 when you toilet backs up and floods your entire house for FREE?  If you do, good luck getting someone to take your call.  Life is such that anything urgent can happen at all hours of the day, not just medicine.  But no one offers 24/7/365 services for FREE.  I take at call at 0500 for the frantic old lady who hasn't had a bowel movement in 3 days (and she always has a bowel movement at 0500, darn it!), yet her Medicare won't pay me a dime for doing it.  Ask your plumber, mechanic, attorney, whatever, when you're hiring them if it  gives you the ability to call them 24/7/365 for ANYTHING for FREE and then get back to me.  Let me know what they say.  And when they look at you like you are nuts, tell me what their response is when you tell them it is their "moral" duty to do so because in their line of work, it is a 24/7/365 obligation.

[Guest JMPA]

hmmm, if i was going to choose a primary care practice would i choose one where i could call if needed or one where they do not accept calls after hours?