Clozapine, a major problem in private practice

[whopper]

For many of you who do not know this, private labs such as Labcorp or Quest often times don't fax results to your office even when you demand they do so and they verify on the phone they will. Same too with several hospital labs. They make no more money by sending them to the doctor. They make their money simply by doing the lab.

So on average less than 50% of the time I get labs and my secretary has to waste a lot of time calling them reminding them to send them to me.

With Practice Fusion I now have a setup where I get the labs directly from Quest but Labcorp despite over 10 attempts to get them linked to my PF acct, they're still stalling. Whenver I call them they just act stupid and don't get me anywhere forward.

Anyway do the math. Weekly Clozapine labs and less than 50% of the time you get them in your office? How many weeks will it take until the patient is screwed because you can't prescribe because you can't see the lab?

Add to the problem that with weekly draws you're probably going to want to see the patient weekly at least for a few months and in private practice it's common to have very few openings and possibly even none for the next several weeks after you first see a patient.

I had a case where Labcorp didn't send me the lab results of a patient requiring that I tell them to go to the ER despite my secretary, the patient, and I calling them telling them to send me the results.

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[psych md jd]

Not a problem for my practice.

Too small for a EHR, so my staff checks for lab results online QAM. Usually get results next day, sometimes same day of draw.

No muss, no fuss.

 

[birchswing]

I check my labs on LabCorp's site and they tell me to the minute when the lab will become available (which is several days after the doctor receives it). I've been pretty impressed. I called in the other day to ask which assay was used for a particular lab test and the person I spoke to knew right away without even looking it up.

 

[Nasrudin]

I've had similar problems at our clinic with the same company. I'd thought it was a personal vendetta. I feel better sharing my misery.

 

[TexasPhysician]

Labcorp is notionally bad at this. I won’t use them.

 

[whopper]

Some insurance companies force their patients to use Labcorp.

It could've been that the patient didn't even get the lab done and lied to me about it, but even if that were true the truth remains that I get labs less than 50% of the time. Only exception to this is Quest but that problem was fixed when I got Practice Fusion.

Same is true with medical records in general. Patient and I request them from their hospital or other physicians and less than 50% of the time we get them despite multiple calls and snail-mails.

I have access to the Labcorp portal but the problem there is that sometimes even when the patient gets the lab done I don't see it. Sometimes, for example, I need to see a another doctor ordered. What I think might be going on it is might only be letting the ordering doctor see the labs but if that's the case no one at Labcorp tells me this is what's blocking the results and they won't unblock them...nor fax me the lab results despite multiple "yes"s on the phone.

 

[Nasrudin]

Some insurance companies force their patients to use Labcorp.

It could've been that the patient didn't even get the lab done and lied to me about it, but even if that were true the truth remains that I get labs less than 50% of the time. Only exception to this is Quest but that problem was fixed when I got Practice Fusion.

Same is true with medical records in general. Patient and I request them from their hospital or other physicians and less than 50% of the time we get them despite multiple calls and snail-mails.

I have access to the Labcorp portal but the problem there is that sometimes even when the patient gets the lab done I don't see it. Sometimes, for example, I need to see a another doctor ordered. What I think might be going on it is might only be letting the ordering doctor see the labs but if that's the case no one at Labcorp tells me this is what's blocking the results and they won't unblock them...nor fax me the lab results despite multiple "yes"s on the phone.

This mirrors my experiences exactly. I feel less like Charlie Brown. I was ready to transfer my patient to another clinic. But then I’m leaving so. I’ve just been getting labs through the PCP for a month or 2 until then. I spent hours on the phone trying to figure it out. Then just gave up.

It’s a shame. Clozapine is a good medication. But in my system I’m less likely to use it given it problems with execution in the field at my clinic.

 

[birchswing]

I check my labs on LabCorp's site and they tell me to the minute when the lab will become available (which is several days after the doctor receives it). I've been pretty impressed. I called in the other day to ask which assay was used for a particular lab test and the person I spoke to knew right away without even looking it up.

I've been calling my endocrinologist's office about this particular LabCorp lab result for over 2 weeks because it came back over twice the upper limit. No response. So I just figured typical office where messages go into a black hole. I called in today and the secretary told me the only way I'd get a response from the doctor is to ask patient relations (this is an out-of-town big academic center that has such a thing, I'm not accustomed to it). So I called there and he got hold of the doctor right away who said she never got the results so had no reason to call me back. I had to use the patient portal to send her my copy of them that the lab gave to me on their portal. Very weird. If patients have an easy to use portal to get all their LabCorp results, don't doctors have something similar?

 

[Echo Three]

labcorp interfaced with practicefusion without fuss and they sent a "courtesy fax" to the pharmacy directly.