Office supplies needed for my clinic rooms?

[DrJackRyan]

I’m starting an outpatient IM practice and the office manager is asking what I would like in my clinic rooms. Any advice for specific things you all need or use in your offices?

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[NewYorkDoctors]

for the primary care side of things I usually include
- manual sphygmomanometer (in case you need to measure pulsus paradoxus.. yea right.. i mean incase the patient is incredulous about the automated reading)
- reflex hammer, tuning fork (for diabetic foot exam and lumbar radiculopathy... not for mononeuritis multiplex workup...)
- tongue depressors / throat swabs
- COVID / viral swabs (depends on your office's pollicy about isolation)
- (optional) opthalmoscope whether direct or panoptic - but see the thread I posted in the optho forum... kind pointless). I recently got the Welch ALlyn Retinavue. that really shored up the patients with DM who just do not want to see ophtho due to... reasons...
- otoscope / rhinoscope / tips
- gauze
- vaccination supplies (unless nurse does it in another room)
- step stool (elderly need help getting onto the bed)
- scale for weight/height (unless MA / nurse does it outside)
- surgilube (in case you want to do rectals/prostates/vaginals)
- Pap smear equipment (my female NP does this in the room) including the fibertopic light and the plastic speculums and the collection tools
- phlebotomy supplies (unless the phlebotomist / nurse does it in another room)
- Snellen chart? if there is enough room.
- suture supplies and wound care supplies (if you are trained in that)
- little diabetic glucose log books and BP log books - might be useful for motivated patients
- sample medications - this is debatable and depends on your practice's style. but i have some samples (the ones that have real benefit not the ones that are super specialized that ill never use) but it wouldnt hurt to have some sample inhaler meds so you can show the patient how to use it (or nurse shows how to use it). you can bill 94664 for showing inhaler technique. you wouldn't believe the # of consults I get for dyspnea and I find no one ever showed the patient how to use the inhaler (but thank you PMD for the softball down the middle of the plate)

that should be the basics and should be fairly okay.

 

[rokshana]

for the primary care side of things I usually include
- manual sphygmomanometer (in case you need to measure pulsus paradoxus.. yea right.. i mean incase the patient is incredulous about the automated reading)
- reflex hammer, tuning fork (for diabetic foot exam and lumbar radiculopathy... not for mononeuritis multiplex workup...)
- tongue depressors / throat swabs
- COVID / viral swabs (depends on your office's pollicy about isolation)
- (optional) opthalmoscope whether direct or panoptic - but see the thread I posted in the optho forum... kind pointless). I recently got the Welch ALlyn Retinavue. that really shored up the patients with DM who just do not want to see ophtho due to... reasons...
- otoscope / rhinoscope / tips
- gauze
- vaccination supplies (unless nurse does it in another room)
- step stool (elderly need help getting onto the bed)
- scale for weight/height (unless MA / nurse does it outside)
- surgilube (in case you want to do rectals/prostates/vaginals)
- Pap smear equipment (my female NP does this in the room) including the fibertopic light and the plastic speculums and the collection tools
- phlebotomy supplies (unless the phlebotomist / nurse does it in another room)
- Snellen chart? if there is enough room.
- suture supplies and wound care supplies (if you are trained in that)
- little diabetic glucose log books and BP log books - might be useful for motivated patients
- sample medications - this is debatable and depends on your practice's style. but i have some samples (the ones that have real benefit not the ones that are super specialized that ill never use) but it wouldnt hurt to have some sample inhaler meds so you can show the patient how to use it (or nurse shows how to use it). you can bill 94664 for showing inhaler technique. you wouldn't believe the # of consults I get for dyspnea and I find no one ever showed the patient how to use the inhaler (but thank you PMD for the softball down the middle of the plate)

that should be the basics and should be fairly okay.

In this day and age, no one should have to do a glucose log book…offices should have the ability to download glucometer information ( glooko or tidepool) and ideally have pts on a cgm in which data can be shared with pcp.

 

[NewYorkDoctors]

In this day and age, no one should have to do a glucose log book…offices should have the ability to download glucometer information ( glooko or tidepool) and ideally have pts on a cgm in which data can be shared with pcp.

but if the patient has coverage issues, copay issues, adherence issues, or other barriers to GCM, then a little booklet is better than nothing perhaps?

but yes I agree I like technology too.

 

[rokshana]

but if the patient has coverage issues, copay issues, adherence issues, or other barriers to GCM, then a little booklet is better than nothing perhaps?

but yes I agree I like technology too.

Practically no one has a barrier to a glucometer… after all how are they putting glucose values in that little book if they don’t have one? Urine dip?
Download the glucometer information.push comes to shove, Walmart sells a relion meter for 20 bucks and strips are 25 cents.

 

[Sushirolls]

Ask that they also get the business cards of Psychiatrists and therapists and any of the other top most referred to people.

More impactful, to walk over to counter/drawer/wall, and pull out the specialist card and hand it to patient, "call them, and get a consult."

 

[NewYorkDoctors]

Practically no one has a barrier to a glucometer… after all how are they putting glucose values in that little book if they don’t have one? Urine dip?
Download the glucometer information.push comes to shove, Walmart sells a relion meter for 20 bucks and strips are 25 cents.

you underestimate how tech un-saavy some older patients really are.

also some Medicaid patients (rightfully so due to their lower means) won't pay or get anything unless it's free.

 

[rokshana]

you underestimate how tech un-saavy some older patients really are.

also some Medicaid patients (rightfully so due to their lower means) won't pay or get anything unless it's free.

Again… how do you think they get a blood sugar level to put in a glucose log??? They use a GLUCOMETER.
There is no need for them to keep a written log when you ( the physician) can download their glucometer.

 

[NewYorkDoctors]

Again… how do you think they get a blood sugar level to put in a glucose log??? They use a GLUCOMETER.
There is no need for them to keep a written log when you ( the physician) can download their glucometer.

yes point taken and agreed upon... but literally some patients are UNABLE to do those tasks. think older, less computer literacy, and especially immigrants from various countries (whom I see many of in NYC). although my staff can help them... they NEVER bring in the glucometer sometimes... hence a little booklet is better than nothing in that case?

jeez you sure are triggered by everything i post. I sure love that prime real estate in your mind that I pay zero rent for 🤣🤣🤣🤣 any room for a hamster wheel up there?

 

[rokshana]

yes point taken and agreed upon... but literally some patients are UNABLE to do those tasks. think older, less computer literacy, and especially immigrants from various countries (whom I see many of in NYC). although my staff can help them... they NEVER bring in the glucometer sometimes... hence a little booklet is better than nothing in that case?

jeez you sure are triggered by everything i post. I sure love that prime real estate in your mind that I pay zero rent for 🤣🤣🤣🤣 any room for a hamster wheel up there?

Have I responded to you before? 🤷🏽‍♀️
As an endocrinologist, it doesn’t make sense to use a tool from the 1990s to treat diabetes in 2023…if they forget their glucometer, they most likely are not remembering a glucose log… or writing in it either.
This would be like using sulfonyreas as first line for DM… it was a good medication 60 years ago, but now? Not so much…

 

[dgdg]

you underestimate how tech un-saavy some older patients really are.

Many of my older patients, who do not need and do not see and endocrinologist, I'm just glad that they check their glucose sometimes. A fair number are not tech savvy, and some have cognitive, visual, or dexterity issues that prevent checking their glucose regularly, let alone have it stored in some electronic device. Even when it is stored in their glucometer, it is not necessarily brought to the office despite my urging. Some would benefit from a closed system like the Dexcom, but cost/insurance is an issue as they are not using insulin or needing to check their numbers frequently. I'd probably have to make appts for each sensor change.
It's a complex process and the Art of primary care medicine. To varying degrees, we have to meet our patients where they are.

 

[rokshana]

Many of my older patients, who do not need and do not see and endocrinologist, I'm just glad that they check their glucose sometimes. A fair number are not tech savvy, and some have cognitive, visual, or dexterity issues that prevent checking their glucose regularly, let alone have it stored in some electronic device. Even when it is stored in their glucometer, it is not necessarily brought to the office despite my urging. Some would benefit from a closed system like the Dexcom, but cost/insurance is an issue as they are not using insulin or needing to check their numbers frequently. I'd probably have to make appts for each sensor change.
It's a complex process and the Art of primary care medicine. To varying degrees, we have to meet our patients where they are.

if they are not tech savvy enough to handle the technology of the 1970s like a glucometer, they certainly are not going to be able to handle a dexcom...maybe a Freestyle Libre, which is easier and has its own receiver.

and you know the pt doesn't have to actively do anything to "store" their glucose levels in the glucometer...it automatically does it.
and they don't bring their glucometer but they "store"and bring their glucose log?

I am Endocrine...if you as a pt are going to see an endocrinologist for your DM, its is a prerequisite to bring in a glucometer if one is checking sugars...but unless the person is on insulin or a SU, there really isn't a reason for them to really check their sugars...if the medication is a glp1a or an sglt2i and has no real risk of hypoglycemia, and a1c is at goal, their glucose checks really aren't going to change management.