(Nearly) Useless Chief Complaint

[shiro1]

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Problem with eye(s)
Failed school screening
Film over eye
My doctor told me to come here.
Headache

Any others?

 

[KC girl]

"I have no idea why I'm here, the VA just sent me an appointment card."

 

[shiro1]

"Why is your child here today?"

"I don't know."

C.C. Complete Eye Examination
😡

 

[Apollyon]

"I have no idea why I'm here, the VA just sent me an appointment card."

You know what, though? Send a vet an appointment card, and he'll (or she'll) be there. Moreover, far and away, they are the most gracious and thankful patients you'll ever get, even when you screw up.

Still, doesn't help no CC, but, it's part of the quid pro quo.

 

[rubensan]

200 AM on a Saturday morning.....

cc: floaters x 5 days

me: are you seeing black spots in your vision?

pt: oh no, i just need my eyes checked. my PMD said that if i said "floaters" i would get seen faster! he also said that i wouldn't have to wait as long early in the morning on the weekends.

NO JOKE!

 

[VA Hopeful Dr]

200 AM on a Saturday morning.....

cc: floaters x 5 days

me: are you seeing black spots in your vision?

pt: oh no, i just need my eyes checked. my PMD said that if i said "floaters" i would get seen faster! he also said that i wouldn't have to wait as long early in the morning on the weekends.

NO JOKE!

Why on earth would you want a standard exam at 2am on a saturday?

 

[OMD]

Please tell me that you didn't actually see this guy at 2am. Hand that guy a clinic appointment card and call the PMD in the morning-although right then would have been even better.

 

[Caffeinated]

You know what, though? Send a vet an appointment card, and he'll (or she'll) be there. Moreover, far and away, they are the most gracious and thankful patients you'll ever get, even when you screw up.

Still, doesn't help no CC, but, it's part of the quid pro quo.

Very true. I've seen military retirees spend almost an entire day in an eye clinic waiting to be seen, getting more tests, waiting for staff, etc. Then, at the end of a long day, they thank you profusely for taking such good care of them. And they spread the love around--they will thank everyone including staff and residents. Even us med students can get some respect and gratitude from this crowd. There is a reason they are called "The Greatest Generation."

 

[rubensan]

oh no, i told him that since "floaters" was already documented on the ER sheet, that i would have to do a depressed exam. let's just say, i saw the ora over and over and over again!

Please tell me that you didn't actually see this guy at 2am. Hand that guy a clinic appointment card and call the PMD in the morning-although right then would have been even better.

 

[ckyuen]

Just remember for the HPI to have four elements or you will get down coded if you are audited. example painless, moderately progressive, bilateral vision loss, 6 months duration. gets you up to the level 4 consult on the cataract when you decide to do the ce/iol at the first visit. In private practice there are no stupid chief complaints it's all patients and revenue so you can pay overhead.

 

[shiro1]

Actually, I am in private practice and therefore I never turn anyone away--even if they show up 2 hours late and are at the very end of the day. I was actually grousing about my pet peeve about chief complaints (another required element for coding) that usually doesn't contribute much to your exam. HPI, when done correctly, contributes a wealth of info for your differential.

Anyway, here's another one: "Just to make sure my (my son/daughter/dad/mom/s) eyes are healthy."