bike mike Posted November 10, 2020 Share Posted November 10, 2020 I gotta say I'm getting very frustrated by some of the local PCP's in my area. I recently saw a patient and when looking over the interrogation of his PPM I noticed a 2.5% burden of AF. Placed patient on AC. I found out today that the patient has not started anticoagulant because his PCP told him not to start any meds the PA orders....only if the cardiologist orders it. WTF? Quote Link to comment Share on other sites More sharing options...
MSPAC2 Posted November 10, 2020 Share Posted November 10, 2020 (edited) I would document exactly that in the patient chart, " 2.5% burden of AF, patient has not started anticoagulant because PCP told him not start any medications the PA orders...only if the cardiologist orders it." Then fax over the visit note to the PCP. But maybe I'm just petty. Edited November 10, 2020 by MSPAC2 1 1 4 Quote Link to comment Share on other sites More sharing options...
bike mike Posted November 10, 2020 Author Share Posted November 10, 2020 1 minute ago, MSPAC2 said: I would document exactly that in the patient chart, " 2.5% burden of AF, patient has not started anticoagulant because PCP told him not start any medications the PA orders...only if the cardiologist orders it." Then fax over the visit note to the PCP. Believe me.....done and done. I just can't believe the poor patient care being provided by the PCP. Just disregard anything a PA says and does even if that means risking a CVA for your patient. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 10, 2020 Moderator Share Posted November 10, 2020 Get the pt in to a cardiologist asap, then when the cardiologist orders AC forward it to the PCP. "In agreement with my prior recommendation , Dr Smith of cardiology concurs that pt start eliquis 5 mg twice daily....." 1 3 Quote Link to comment Share on other sites More sharing options...
CAAdmission Posted November 10, 2020 Share Posted November 10, 2020 Make sure the patient knows his PCP screwed up, too, and have him ask about it. 1 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted November 10, 2020 Moderator Share Posted November 10, 2020 You all are better than me. I would tell him that if I heard of him telling patients not to follow the standard of care through legal and valid PA orders, then he would be reported to the board for patient endangerment. 3 2 Quote Link to comment Share on other sites More sharing options...
Cideous Posted November 10, 2020 Share Posted November 10, 2020 "Assistants...." Quote Link to comment Share on other sites More sharing options...
CAAdmission Posted November 10, 2020 Share Posted November 10, 2020 2 hours ago, LT_Oneal_PAC said: You all are better than me. I would tell him that if I heard of him telling patients not to follow the standard of care through legal and valid PA orders, then he would be reported to the board for patient endangerment. That could actually be a lot of fun. He'd get called in and have to answer to the board. Nothing would happen, but it would ruin his day for sure. 1 Quote Link to comment Share on other sites More sharing options...
CAAdmission Posted November 10, 2020 Share Posted November 10, 2020 14 hours ago, bike mike said: his PCP told him not to start any meds the PA orders....only if the cardiologist orders it. WTF? On another note, if the cardiologist is your supervising physician, he should tell the other doc to go fornicate himself. 2 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted November 10, 2020 Moderator Share Posted November 10, 2020 22 minutes ago, CJAadmission said: On another note, if the cardiologist is your supervising physician, he should tell the other doc to go fornicate himself. and detail to that idiot pcp how much more YOU know about the topic than the pcp does.... this is an ongoing problem for both PA and NP specialists. A decent number of us know more about our specialty than the vast majority of non-specialist physicians, yet we don't get that acknowledgement very often....and it is sucks and it's overdue. 2 2 Quote Link to comment Share on other sites More sharing options...
bike mike Posted November 10, 2020 Author Share Posted November 10, 2020 (edited) I am getting the patient in to see the cardiologist ASAP. I am sending my last OV note to the PCP with a copy of the pacer interrogation. I came very close to calling him but held back because I'm sure I would have flipped my lid. I've had run ins with two of the local PCPs over these kinds of issues. One is in his late 60's and the other in his mid 70's. I'm sure they never worked with a PA in their life. Whenever a PCP gives me a hard time about being a knuckle dragging PA I always think of the time when I was working in the CCU and some big shot brought his personal PCP in with him. When the patient coded 15 minutes after arriving the PCP literally ran screaming from the room while I ran the code and got him back. Edited November 10, 2020 by bike mike 3 1 2 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted November 10, 2020 Administrator Share Posted November 10, 2020 Guys, one word of caution here: Patients can SAY their PCP said all sorts of things, and they might even be accurately reporting what they THINK the PCP said, but there's going to be some amount of patients misconstruing what another provider said. I'd encourage a phone call first, just to confirm that the provided did in fact say what the patient said he or she did. 3 4 Quote Link to comment Share on other sites More sharing options...
surgblumm Posted November 12, 2020 Share Posted November 12, 2020 I agree with Rev Ronin----if it wasn't written, it didn't happen. There was not enough intelligence gathered to take a pre-emptive strike. Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.