Wednesday, July 29, 2009

Gratuitous comanagement

Happy Hospitalist ranted over at Hospitalist With A View on getting consulted by surgeons for “medical follow up”:

If there is an acute issue that needs to be addressed, elevated blood pressure, abnormal blood sugar, chest pain, fever I am more than happy the evaluate patients who need a physician specialist as my self to evaluate an acute issue. This is not general medicine. This is internal medicine.If you are asking me if I am happy to see post op surgical patients to write discharge orders, address home meds and field nuisance pages, then you must be mistaking me for someone you should be hiring to do your work for you.

Wait a minute, Happy, haven’t you heard of comanagement?

He went on:

Does consulting me make it medically necessary? Well, Medicare and their carriers seem to think so. No claim is ever rejected. So what am I to do? Do I say no to the physician's request? Or do I do it and submit a claim.

Well, you could see the patient, submit a claim for your initial visit and then, having determined that there is no acute problem in need of your expertise, sign off. That’ll get you out of the loop for those nuisance pages and the discharge planning which should really be the responsibility of the surgeons or their PAs. Keep up the clerical scut work and you won’t be a Happy Hospitalist much longer.

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