Question for the medical masses.

Why don’t doctors assess their patients when they come back with abnormal labs or other benign issues? Many PHPs around here employ Nurse Practicioners and Physician Assistants, but they still send every little issue to the ED for evaluation. What is the role of PHP for nurings home patients?


About Joel

I am a paramedic, firefighter and I work for an organ procurement organization. All stories related to work have been altered to HIPPA standards and for the protection of those involved. The personal stories are different. Photography, flying, aviation, hiking, camping, travel, geocaching, amateur radio are a few of my hobbies.
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4 Responses to Question

  1. PHP or Primary Care Physicians, need to get people in the door and out ASAP to maximize billing. By passing off re-evaluations to other sub specialties they can double up on people coming through the office while still passing along the actual work to he most expensive part of the system, emergency.
    Funny thing is, if they schedule the follow up tests outside of emergency, it costs the system less in the long run.
    Another reason for healthcare insurance reform.

  2. Elle Künstlerin says:

    The doctor’s role for nursing home patients is to write prescriptions, (hopefully) sign DNRs and call codes. Otherwise I’ve never seen a NH doctor at a nursing home nor have I ever transported a NH patient to a routine doctor’s check-up.

    I wonder how much a NH can actually deal with abnormal labs. Do they have the materials necessary to treat something like hyponatremia on site? If not, then it makes sense in a stupid way that they send patients to the ER. Plus it takes repeat monitoring to check the patient’s response to treatment and no NH is able to do that.

    Now the real question is, why do they call 911 for abnormal lab values at 3am when you know they didn’t get the results at 2:45am? 🙂

    • rescuemonkey says:

      Maybe nursing homes are obsolete & we should have extended stay hospitals? A nursing home can order meds & check vitals. I object to the MD/NP/PA to automatically sending everyone to the ED. PT/INR too high, yes that requires hospitalization so admit the patient to the hospital, don’t just drop responsability on the on call consultant. The MD for nursing homes just appear very lazy. Why send the patient out at 3am? Cause 1st shift didn’t want to do the paperwork. Most labs are done in the morning. More laziness.

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