- May 26, 2007
- Reaction score
The problem, though, is that specialists seem to have a very wide range of opinions on what constitutes a 'full' clinic. I have seen specialists insist on 30, 45, and 60 minute appointments. Half days of admin. Full days of admin. Additional half days for collaterals. They are all ''full' in the sense that they book every appoinent they have, but is that really full? Should that kid really have been waiting those six weeks? Or should you have have more appointments?There should be a good relationship. Educating on referral guidelines should happen. Primary care clinics should feel comfortable calling subspecialists and asking for direction without getting badgered. The point is, it should be a cooperative relationship. The subspecialists shouldn't be rejecting referrals simply because they don't want to see patients. If they have the time, they should be seeing things, even if they think they weren't necessarily appropriately worked up, so long as it's actually something they treat (ie: I would get TMJ consults all of the time, and I don't treat TMJ, they needed to go to their dentist). But the other side of that coin is that subspecialty clinics aren't just a dumping ground where PCPs can send patients because they feel overloaded. I was essentially never running a slow clinic with available spots. Seeing a patient for allergies who had never been prescribed any treatment of any kind was a 10-15 minute appointment slot that could have been managed at the PCP level. If they fail there, then I'm happy to see the patient. But instead I'm seeing an irate patient who waited 6 weeks to see me so that I could put him on flonase. Plus, my next patient is a 2 year old who hasn't been able to hear well for 4 months because he had to wait an extra 6 weeks to see me because my clinic is full of guys who just need flonase. There's a difference between not knowing how to manage a semi-complex issue as a primary care provider, and just dumping things on specialists because you're busy.
But there should be a dialogue there as well. From both sides.
I don't know your schedule at all and I'm only 90% sure I even know your specialty, so no judgement. However when a military subspecialisty rejects my patient because they are full and tells me thar I should be able to handle it I hope that means they are staying later at work than I am.