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So I'm just curious.
This forum seems to have a number of people in private practice (I'm talking small, psychiatry only groups), and seems to advocate that this form of practice as desirable for a number of reasons.
My concern about that would be, though, how do you keep abreast of what's going on with your patients medically? How do you get requisite labs and workup?
Whenever I have patients who need EKG's, blood draws, urine drug screens, etc, more than half the time it's like herding cats getting people to do those things. I'm part of a university system, but our clinic doesn't have a lab in the building, so we send people to primary care clinic down the street. Still, the half-mile they need to drive seems to be an insurmountable barrier to many people. One psychiatrist in our department has started doing his own UDS's, but those are just dipstick ones: not as reliable as ones done in a lab, and we're not equipped to make sure the sample wasn't tampered with.
Coordinating with PCP's (i.e. when someone's stable and can go back to primary care, or needs a medical issue taken care of) is ok if the PCP is in our system. But if they're not, it eats up my and my RN staff's time with paperwork and phone calls. And a lot of the time, patients aren't reliable reporters of their own health status so not being able to review that info in the chart makes me uncomfortable.
Finally, I find myself needing to order a lot of sleep studies. I have no idea what I'd do if there wasn't a sleep clinic in our system.
How does everyone else in solo or small group private practice deal with this?
This forum seems to have a number of people in private practice (I'm talking small, psychiatry only groups), and seems to advocate that this form of practice as desirable for a number of reasons.
My concern about that would be, though, how do you keep abreast of what's going on with your patients medically? How do you get requisite labs and workup?
Whenever I have patients who need EKG's, blood draws, urine drug screens, etc, more than half the time it's like herding cats getting people to do those things. I'm part of a university system, but our clinic doesn't have a lab in the building, so we send people to primary care clinic down the street. Still, the half-mile they need to drive seems to be an insurmountable barrier to many people. One psychiatrist in our department has started doing his own UDS's, but those are just dipstick ones: not as reliable as ones done in a lab, and we're not equipped to make sure the sample wasn't tampered with.
Coordinating with PCP's (i.e. when someone's stable and can go back to primary care, or needs a medical issue taken care of) is ok if the PCP is in our system. But if they're not, it eats up my and my RN staff's time with paperwork and phone calls. And a lot of the time, patients aren't reliable reporters of their own health status so not being able to review that info in the chart makes me uncomfortable.
Finally, I find myself needing to order a lot of sleep studies. I have no idea what I'd do if there wasn't a sleep clinic in our system.
How does everyone else in solo or small group private practice deal with this?