Rant about primary docs doing nerves

[neurolddoc]

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Ok here is my rant.

Multiple times in the last few months I have gotten patient referred to me for internists of FP's who have somebody come into their office to do NCT's on them and then when they have no clue what they actually mean, send the patient to me to figure out what is wrong. Most of the time I can talk the patient into having studies repeated, as the first studies were "inconclusive". Occasionally there is push back from the patient who said "i just had theres done" and refused to get them. In that particular instance we called to get the results of the NCT's and was told that "it's within normal limits" but that there was no data about latencies, velocities, etc. to send. I find I have to be very careful to not say something disparaging about the primary's test which could get back to the primary and piss them off.

All in all it may be a good thing if Medicare/insurers clamp down on NCT/EMG reimbursement, as a lot of shady business is going on. It's probably a good thing that some insurers won't pay for nerve studies without an EMG being done with it.

I feel bad about them making little money and all but seriously, stick to something they know something about.

 

[Phantom Spike]

Ok here is my rant.

Multiple times in the last few months I have gotten patient referred to me for internists of FP's who have somebody come into their office to do NCT's on them and then when they have no clue what they actually mean, send the patient to me to figure out what is wrong.

The other major stumbling block in this situation is insurance companies refusing to pay for a second study for six months, even if the first study was suboptimal. So you end up with a patient who's been referred to you for an "abnormal nerve conduction study", and you can't repeat it or tell the patient or the referring physician what's wrong (if there is anything wrong in the first place), leading to frustration all around.

 

[BrainBuff]

stick to something they know something about.

Be very careful of what you wish for. The next step will be that only those who are fellowship trained in Neurophysiology will be able to obtain reimbursement. Then, those who are board certified in the subspecialty. It is the way it will eventually go....

Neurologists should not complaint too much about the nerve conduction studies situation. After all, they "took" that from the PM&Rs specialists who were the only ones performing them back in the 70s and early 80s. And let's not forget about all the CT, MRI readings and Carotid Doppler studies that neurologists have been reading for years....

Do not rant too much, please...

 

[neurolddoc]

The primary difference between neurologists reading CT, MRI, etc. is that they, by and large know what they are looking at and have in most cases spent years finding the mistakes of general and even neuroradiologists. The whole point of my rant is that these people haven't the foggiest notion of what the page of numbers means.

Also I think requiring specific training and/or certification for testing modalities would be a good thing.