Quarterly IM help in primary care

[MCHAD]

Wasn’t sure what to put in the title for this one but here’s the situation. 

Our rural primary care clinic has had an internal med doc coming in every 3-6 months for “complicated patients” for years...we now have 4 PA’s that rotate (I’m one of them) and also our medical director who comes in twice a month.  The internal medicine doc is nice but every time he’s due to visit they beg us to give suggestions for who he should see.  I guess in the past he has gone in with the NP that used to work here and advised on patients.  Those of us that currently work here feel like we don’t really need him because the “complicated patients” already have multiple specialists and we have a medical director that we can consult with if necessary as well.  

Currently he sees patients, makes suggestions, doesn’t refill and chronic medications because he says he’s not here often enough to be anyone’s PCP, and if we don’t get enough patients for him to see the clinic loses money because he’s paid a flat rate.  Administration has asked those of us currently working here what we think of the situation and we have all said that while he is nice he isn’t here often enough to really help us and isn’t really available for phone consults.  His contract was just renewed and we aren’t really sure why.  I mean he’s a nice guy but all he seems to add to our clinic is stress because we can potentially lose money on him.  

I may not have painted this picture well but any thoughts? 

[sas5814]

I think you painted the picture pretty well and it sounds like admin already has an idea they may be wasting money. I suspect with time it may change.

In the interest of my own sanity I removed myself from decisions made by other folks that I have no control over. I think you guys gave your input and now its up to admin to do something with it. I don't think there is any added value in worrying about something you don't control.