Warning… Family Physician rant. That is the perspective this is coming from so take it with a grain of salt….
I’m am so tired of all these hospitals and specialty clinic slapping a bandaid on my patients’ problems and giving them a plan to “follow up with your primary care doctor”
Or waiting six months and having my patients pay a lot of money to tell them, “looks like everything is going great, continue with your primary care doctor and see me again in six months”
These patients are not coming to your facilities because everything is going great in my clinic. If I had the diagnosis and treatment plan nailed the specialist or hospital would not be involved. If a patient is showing up in that exam room the primary care office can’t handle the problem.
For example
If you transfuse a patient because they are so anemic, we need to know why they are anemic to “follow up with pcp”
If my patient is missing work and vomiting all the time and the colonoscopy didn’t fix it, I need a diagnosis and treatment plan beyond “functional abdominal pain follow up with PCP.”
If my patient is suicidal they need to feel safe calling the psychiatrist and confident they will get help.
Give me a list if possible diagnosis, some medications to try, some labs or next steps even. At least point me in the right direction.
We are all overwhelmed, every system, every specialist. I’m doing my best to own these patients but I don’t have the knowledge and usually don’t have the equipment to solve the problem.
Please stop kicking these patients back to the PCP. I usually have half the time, less available staff, and I get paid 50-70% as much as a specialist for what I do. I take my own vitals, I fill out all my prior auths and insurance paperwork. I personally call back 90% of the clinic calls to answer questions. My reimbursements don’t allow margins for much support staff to help with all that.
Also all the specialists that are sick of inappropriate referrals and hospital/ER utilization… totally valid, I personally apologize and admit I make that mistake at times. We get it wrong too, we need to better on that front as primary care providers. I can admit that.
As doctors though we are losing a lot of confidence from patients. They feel like they are constantly paying hundreds of dollars to basically be told “I can’t help you, talk to a different doctor”
We need to do better.
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