Rural - Specialist F/u vs PCP F/u

[SuckySurgeon7]

1 - Hey y'all, if you have an osteo or endocarditis patient, and you're a hospitalist in a rural area without ID around for >1 hour, do you end up sending them to follow up with a local PCP to monitor interval CRP/ESR (osteo)? Or do you make sure they see an ID doc even if the distance is significant?

2 - If you treat these patients without an ID consult (lack of ID at your hospital, etc), does this make a significant difference in your choice?

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[tantacles]

1. I send them to see ID because if you're going to be on IV antibiotics for 6 weeks, you need ID. I consider this outside of the scope of a PCP. After the first appointment, the ID doctor can work with the patient to determine appropriate interval follow up, which may or may not, depending on the specialist, be related to distance from the specialist.

2. n/a