quietmedic Posted May 19, 2019 Share Posted May 19, 2019 I was offered a job for home assessments (I assume Mc/Mc type assessments) in NY for geriatric patients not seen in the past year. As I understand, this is for assessment only, no specific interventions. I was trying to figure out if this sort of thing is medico-legally risky (like if there is something that needs nonemergent but urgent treatment, but I am told or required to leave it to the PCP, is that abandonment/failure to act/etc.?) Any general thoughts from those who have done similar jobs? Thanks! Quote Link to comment Share on other sites More sharing options...
Cideous Posted May 20, 2019 Share Posted May 20, 2019 I see those jobs from time to time pop up. They seem a bit sketchy and I think you must submit your own medicare eval reports which can be epic long. Talk to someone actually doing it first. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 20, 2019 Moderator Share Posted May 20, 2019 minimal risk.... also minimal pay.... I have looked into these and the hourly seems great, but then they forget to tell you 50% of the people are not home.... so you only get 50% of that.... then it stinks, and I have heard the paperwork is off the charts silly... Quote Link to comment Share on other sites More sharing options...
AlteredBeast Posted May 22, 2019 Share Posted May 22, 2019 If you're looking to do the medicare type wellness exams, (I assume that's what's going on here.) You want to look for a group that usually has a separate department specifically designated to see the patients in this manner while also having the full gambit of pt services, pcp, specialty clinics, etc so you can refer the pt to the appropriate service when you find some pathology. You will find pathology. I don't know about the home health version, I imagine the work is much the same, it is very low stress and usually well paying, at least around here (California). Quote Link to comment Share on other sites More sharing options...
quietmedic Posted May 22, 2019 Author Share Posted May 22, 2019 (edited) 12 hours ago, AlteredBeast said: I don't know about the home health version, I imagine the work is much the same, it is very low stress and usually well paying, at least around here (California). Thanks....yeah, it's the home version, I assume they have no other departments...that's my concern, is there a risk of a malpractice suit, if you are a PA but not acting (and not permitted by the company to act) in the scope of a PA...just as an "assessor"...i.e. the patient obviously needs X prescription, but you are told to leave it to the PCP that the patient will be told to follow up with... On 5/20/2019 at 2:34 PM, ventana said: minimal risk.... What might that risk be, I wonder, in light of my concerns about not performing with a full PA scope of practice, and possibly abandoning a patient who needs further care...not even sure who to ask about this stuff.... Edited May 22, 2019 by quietmedic Quote Link to comment Share on other sites More sharing options...
AlteredBeast Posted May 22, 2019 Share Posted May 22, 2019 Technically the scope of practice is determined by the supervising physician at the practice level, regardless of what you are capable of. You are not the pcp I presume, so chronic problems are referred to them. If it is acute you would send to UC? Or treat? I've never done home health, not sure. Quote Link to comment Share on other sites More sharing options...
quietmedic Posted May 23, 2019 Author Share Posted May 23, 2019 20 hours ago, AlteredBeast said: If it is acute you would send to UC? Or treat? I've never done home health, not sure. That's ultimately the question. Like if I walk in there, and it's a situation that might need more emergent assessment, or needs a full workup, the visit just went from wellness assessment to full emergency room DDX... Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted May 23, 2019 Moderator Share Posted May 23, 2019 1 hour ago, quietmedic said: That's ultimately the question. Like if I walk in there, and it's a situation that might need more emergent assessment, or needs a full workup, the visit just went from wellness assessment to full emergency room DDX... nope and nope you are not the treating provider - call 911 or their PCP - a no brainier... Quote Link to comment Share on other sites More sharing options...
quietmedic Posted May 24, 2019 Author Share Posted May 24, 2019 6 hours ago, ventana said: nope and nope you are not the treating provider - call 911 or their PCP - a no brainier... Thanks....sorry, would you be able to explain a bit more? Sorry, just never really learned the medico-legal rules well...I'd look them up, but no clue where to find this sort of question. Isn't the fact that I am a PA set up an expectation of a certain standard of care...and if I fail to act, even at the PCP's express instruction, or a the instruction of my SP (who I assume has a full MD scope of practice regardless of being employed as an "assessment" doc) isn't that a failure to act/dereliction/negligence? Thanks, sorry for what might seem to be simple questions...if you could point to me to the correct medicolegal resource for this, I'd be grateful, if such exists... Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted May 24, 2019 Share Posted May 24, 2019 "Act" doesn't necessarily mean managing the situation yourself. It can and often does mean sending the patient to the appropriate resources. So, if you are doing a home visit and encounter something that needs further attention, you just start that process, whether it needs non-emergent OP f/u or emergent transfer to an ED. 1 Quote Link to comment Share on other sites More sharing options...
quietmedic Posted May 28, 2019 Author Share Posted May 28, 2019 On 5/24/2019 at 3:02 AM, ohiovolffemtp said: "Act" doesn't necessarily mean managing the situation yourself. It can and often does mean sending the patient to the appropriate resources. So, if you are doing a home visit and encounter something that needs further attention, you just start that process, whether it needs non-emergent OP f/u or emergent transfer to an ED. Thank you, I guess that makes sense. With there was a good guidebook on these sorts of medico-legal vagaries for PAs. (Perhaps there is?) Quote Link to comment Share on other sites More sharing options...
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