You son of a gun. You left out medical students. Lol jk.
Haha.
cool. what kind of support services do you have in the attending office / resident's clinic you work at?
Hopefully they provide you with lots of services to make primary care "easier" to perform?
on site phlebotomy? medical assistants for EKGs, audiometry screenings, Snellen, Retinavue for DR (if applicable), Pap smear assistance, SBIRt screening, etc? Nurses for vaccinations, IVs, smoking cessation, MMSE, etc? support services for prior authorizations? fairly easy subspecialist and radiology referrals?
someone to help keep track of those BIRADS3, TIRADS 4, LungRADS3 lost to follow up?
the biggest barrier for many residents to do PCP is that their resident clinics are so "dependent on the resident to do all of those above mentioned things" that it turns many of them off to it
ah yes great question! I will preface this that my experience is
NOT the majority in my shop. I am very lucky to work at the "main" clinic of our hospital system, so my experience is different than the "satellite" clinics. Unfortunately I feel like there is a hierarchy in academics in terms of support with the main v suburban satellite clinics.
our clinic is staffed by triage RNs, APNs, full MAs, front desk staff, schedulers, etc. Because we have so many docs in my site we have enough volume/revenue to justify hiring the above. Smaller clinics don't have the volume$ to subsidize this.
yes- on site phlebotomy,
MAs do EKG, vaccines, medicare AWV forms, we have a bunch of metrics we have to hit for quality/revenue reasons so they do all the paperwork.
Pap smears- I am a guy so a lot of patients "want" a women to do it, I punt to our great APNs or send patients to OBGYN down the hall.
For PAs- I don't know how to do them lol, we have a pharmacy in our building so I usually in basket the pharmDs, or I have our Triage team do it on covermymeds.
Specialist referrals are department specific. Some departments are really good (they want the RVU$) so they will see the patient for any reason very quickly. mostly surgeons who need to pay for the second wives or their horses (that was a joke lol)
Cognitive specialties are harder. You can get people in within a couple months. At this point I know all the specialists who I like so I usually just in basket the doc myself to get them in.
for radiology findings, for anything more than BIRADS/lung rads that are abnormal, we have a RN coordinator who manages this. for TR-RADS I usually punt it to the endocrine surgeon who is my friend who likes the FNA.
I feel for the residents, they have to do this themselves. But for the attending there is support.
Keep the questions coming!