Jump to content

Texas rules on seeing a MD on request


Recommended Posts

So lately we have had some patient's request to see the MD only.  That is honestly no skin off my back and  I am happy to let the MD see these people.  As I recall there is a law in Texas that says the patient has the right to see a MD if they request.  Does anyone know where I can find the text to that law? 

Link to post
Share on other sites
  • Moderator

love these.....

 

front office says something like this....

The Doctor has an appointment in about 6 months from now, the PA can see you next week.......

 

personally I agree with you - no skin off my nose - let em go they are usually the high maintenance ones..... 

  • Like 1
  • Upvote 1
Link to post
Share on other sites

 some patients may make an appointment with you, then throw a fit to see an md sooner.  This may be why you want the wording.  You don't need to have an md in the closet ready to jump out at their demand.  I had a lady argue with me, she did not listen when I told her the md was for me to consult with. 

 

Link to post
Share on other sites
1 hour ago, ventana said:

personally I agree with you - no skin off my nose - let em go they are usually the high maintenance ones.....

agreed...at my old FM job had a patient that I happened to see as a walk-in.  They were extremely upset they had seen me instead of a doc and were trying to retroactively refuse to pay their copay or consent to us billing their insurance.  Long story short...what I saw them for ended up with me ordering lab tests, that for some reason they actually had drawn (doesn't really make sense).  Then when the results were HIGHLY concerning for cancer they wouldn't come back to see me or even allow me to discuss their results with them over the phone.  I did have their results mailed to them, sent a referral to oncology, and ordered followup testing that the patient 100% ignored.  They REQUIRED that they have an appointment with their doc, who was currently on a 6 month sabbatical in Costa Rica.  Unfortunately the patient never actually got to see their doc as they passed, presumably from the cancer, before he returned.  Just stupid...and was the point where I honestly stopped caring about fighting with patients over their own stupidity.  I make my recommendation(s) and then move on.

  • Like 3
  • Upvote 1
Link to post
Share on other sites

In my many years - pushing 30 of them - I would say that 99% of patients who INSIST on seeing a "real doctor" have a secondary gain issue - mental health issue - personality issue - or all of the above.

I had a patient want to refuse a copay and "force" the doc to see them. Doc wasn't in town. 

Given options of going to ER for 6 hr wait and $250 copay or see me - they chose me. 

I wasn't particularly warm and fuzzy but very clinical and straightforward. 

Found the problem, got the fix started and provided documentation from medical literature regarding their issue and need.

Same patient made a follow up with me within 2 months. Wouldn't say - hey, you turned out to be smart or whatever - but came back. 

So, my smarts won out, I guess.

The rest - let em wait. 

I am a native Texan, born and raised. Texas has always been behind the rest of the nation in PA privileges and overall common sense - very good ole boy and Bible Belt, patriarchal and "little lady" - if they actually have this written down somewhere - wouldn't surprise me a bit. Probably something that says you don't have to see a woman either. Their whole medical board needs a come to glory - join the 21st century awakening.............

  • Upvote 2
Link to post
Share on other sites

Yes, there used to be a stipulation in the guidelines allowing for a patient insisting on physician assessment. This was during the time in which the patient had to be acknowledged during the visit by the physician. We were not allowed to “diagnose” thus we were not allowed to see them in the office without a physician being immediately accessible. There also used to be a stipulation regarding how much you had to work during a two year cycle to maintain licensure once licensure actually occurred.

Link to post
Share on other sites

 

What are supervision requirements in Texas? Is there always a physician in the house?

 

When I was in private practice I would tell my scheduler to never book these patients with me ever again.

Now I work for a big group and I don't think that would fly, but haven't had the issue come up yet.

Edited by Arthropathy
Link to post
Share on other sites

Arthropathy that is the stance I have taken and have pushed them to the SP.  Neither myself or the other APPs I work with do not mind letting them see these patients as we have a full load of patients without them.  I am just looking for someone that can point me to the law in Texas on this one.  I remember learning about this in school years ago but wanted to ask the brain trust here if they can point me to it in writing.  Personally I do not want to see them if trust cannot be built in the first place.  I can always remember that you rarely get sued by friends and those that trust your judgement.  Thank you for removing the apostrophe Medicine Power.

Link to post
Share on other sites
  • Moderator

There is no state law that mandates that if a patient asks to see the physician that you must allow them.  There may have been in the past, but there is no current law that says this

It’s good to ask for the exact wording, but My bet is you won’t find it.  Can’t quote something that doesn’t exist.

Link to post
Share on other sites
1 hour ago, NeoTrion said:

Arthropathy that is the stance I have taken and have pushed them to the SP.  Neither myself or the other APPs I work with do not mind letting them see these patients as we have a full load of patients without them.  I am just looking for someone that can point me to the law in Texas on this one.  I remember learning about this in school years ago but wanted to ask the brain trust here if they can point me to it in writing.  Personally I do not want to see them if trust cannot be built in the first place.  I can always remember that you rarely get sued by friends and those that trust your judgement.  Thank you for removing the apostrophe Medicine Power.

It only takes a moment to look up the rules/regs at the TMB website.  It took maybe two minutes to read through the regs from the time I clicked on the TMB website.  At my last position before retirement  one of the two SP's was maybe in the clinic one day a year, if that.  They do not have to be onsite, only available via phone, text, etc.

Edited by GetMeOuttaThisMess
Link to post
Share on other sites

In most the states I've worked in, the "supervision" was mostly for the PA to consult with, not for the patient to demand access.  If they are scheduled with a PA when expecting an MD, that's bad form, like if I order a cheeseburger, but get a steak. 

(personally, if I was scheduled with an MD, but a PA entered the room, I'd consider it an upgrade.  But that's just me).

  • Like 2
  • Upvote 1
Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...

Important Information

Welcome to the Physician Assistant Forum! This website uses cookies to ensure you get the best experience on our website. Learn More