3 visits only, then MD?

[N701DS]

New grad here and in a relatively new pain clinic. Quick question for you seasoned pros regarding the number of visits before the MD is required to see the patient. Our practice is on the fence with this. As I read it, we can only see a patient 3 times. After that, the MD has to see them.

 

I am new so I tend to be exceptionally cautious. Some in the practice think that the MD is only "required" to see them every third visit if they are not progressing.

 

How do you guys do things?

[N701DS]

New grad here and in a relatively new pain clinic. Quick question for you seasoned pros regarding the number of visits before the MD is required to see the patient. Our practice is on the fence with this. As I read it, we can only see a patient 3 times. After that, the MD has to see them.

 

I am new so I tend to be exceptionally cautious. Some in the practice think that the MD is only "required" to see them every third visit if they are not progressing.

 

How do you guys do things?

[N701DS]

New grad here and in a relatively new pain clinic. Quick question for you seasoned pros regarding the number of visits before the MD is required to see the patient. Our practice is on the fence with this. As I read it, we can only see a patient 3 times. After that, the MD has to see them.

 

I am new so I tend to be exceptionally cautious. Some in the practice think that the MD is only "required" to see them every third visit if they are not progressing.

 

How do you guys do things?

[SocialMedicine]

I have never heard of either policy before at the state level. maybe this is an institutional policy ? most of my patients are "my patients" and do not follow up with other people. im not sure how useful it would be to have an MD evaluate a patient every 3-4 visits just because he is an MD ... sounds like a waste of time and money and not anything of benefit for the patient. I find it very hard to evaluate patients at random when someone else has been caring for a number of chronic issues. maybe in certain specialty settings where the PA is providing specific services directed by an MD this could be an effective method ... such as the psychiatry PA handles talk therapy and medication management and every few visits the MD reviews medications and patient progress. It is much easier to for a physician to sign off on a patient by reading a "medicine chart" ... yet psychiatry and pain mgmt and other medicine areas face to face is more important

[SocialMedicine]

I have never heard of either policy before at the state level. maybe this is an institutional policy ? most of my patients are "my patients" and do not follow up with other people. im not sure how useful it would be to have an MD evaluate a patient every 3-4 visits just because he is an MD ... sounds like a waste of time and money and not anything of benefit for the patient. I find it very hard to evaluate patients at random when someone else has been caring for a number of chronic issues. maybe in certain specialty settings where the PA is providing specific services directed by an MD this could be an effective method ... such as the psychiatry PA handles talk therapy and medication management and every few visits the MD reviews medications and patient progress. It is much easier to for a physician to sign off on a patient by reading a "medicine chart" ... yet psychiatry and pain mgmt and other medicine areas face to face is more important

[SocialMedicine]

I have never heard of either policy before at the state level. maybe this is an institutional policy ? most of my patients are "my patients" and do not follow up with other people. im not sure how useful it would be to have an MD evaluate a patient every 3-4 visits just because he is an MD ... sounds like a waste of time and money and not anything of benefit for the patient. I find it very hard to evaluate patients at random when someone else has been caring for a number of chronic issues. maybe in certain specialty settings where the PA is providing specific services directed by an MD this could be an effective method ... such as the psychiatry PA handles talk therapy and medication management and every few visits the MD reviews medications and patient progress. It is much easier to for a physician to sign off on a patient by reading a "medicine chart" ... yet psychiatry and pain mgmt and other medicine areas face to face is more important

[N701DS]

The paragraph in question reads:

 

[h=2]18VAC85-50-110. Responsibilities of the supervisor.[/h]The supervising physician shall:

1. See and evaluate any patient who presents the same complaint twice in a single episode of care and has failed to improve significantly. Such physician involvement shall occur not less frequently than every fourth visit for a continuing illness.

 

[h=3]Virginia Administrative Code - Virginia Department of Health ...[/h]

[N701DS]

The paragraph in question reads:

 

[h=2]18VAC85-50-110. Responsibilities of the supervisor.[/h]The supervising physician shall:

1. See and evaluate any patient who presents the same complaint twice in a single episode of care and has failed to improve significantly. Such physician involvement shall occur not less frequently than every fourth visit for a continuing illness.

 

[h=3]Virginia Administrative Code - Virginia Department of Health ...[/h]

[N701DS]

The paragraph in question reads:

 

[h=2]18VAC85-50-110. Responsibilities of the supervisor.[/h]The supervising physician shall:

1. See and evaluate any patient who presents the same complaint twice in a single episode of care and has failed to improve significantly. Such physician involvement shall occur not less frequently than every fourth visit for a continuing illness.

 

[h=3]Virginia Administrative Code - Virginia Department of Health ...[/h]

[greenmood]

Reads to me that if a patient comes in for an acute problem and then returns for the same acute problem (your treatment having failed to cure/halt progression), the MD is obligated to see the patient. For a continuing (read: chronic) illness, the MD is required to eyeball the patient on every fourth visit. So a patient who comes to your clinic every three months for A1C checks would need to be seen once a year by the physician.

 

Any other takes?