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How much do you charge for it ? I find since starting my new office, I seem to have a lot of patients who are resistant to coming in, they want me to phone in everything from antibiotics to diabetes meds. I guess my former partner did some of this on my days off. Also there is still that transition going on, the patients are all used to having that "firewall" of receptionists and nurses to speak to first and are all shocked when I answer the phone. Its almost like, "I thought I could leave a message and you would absent mindedly call in a years worth of oxy-contin". Anyway, when I tell people I can see them today for this problem, I get about a third who tell me how incredibly busy they are, it might be nice to do virtual office visits for a few of them, especially for things like blood pressure logs or blood sugar logs. Of course those are not usually the people who don't want to come in. Sorry, got a little wordy there. I'd love to hear if you have any ideas.

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How much do you charge for it ? I find since starting my new office, I seem to have a lot of patients who are resistant to coming in, they want me to phone in everything from antibiotics to diabetes meds. I guess my former partner did some of this on my days off. Also there is still that transition going on, the patients are all used to having that "firewall" of receptionists and nurses to speak to first and are all shocked when I answer the phone. Its almost like, "I thought I could leave a message and you would absent mindedly call in a years worth of oxy-contin". Anyway, when I tell people I can see them today for this problem, I get about a third who tell me how incredibly busy they are, it might be nice to do virtual office visits for a few of them, especially for things like blood pressure logs or blood sugar logs. Of course those are not usually the people who don't want to come in. Sorry, got a little wordy there. I'd love to hear if you have any ideas.

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I personally think you

just have to make them come in. Virtual visits just sound like a set up

to me for a medico-legal meltdown. Face to face visits should be set as

the office standard from day one.

Re:

Virtual Office Visits

How

much do you charge for it ? I find since starting my new office,

I seem to have a lot of patients who are resistant to coming in, they want me

to phone in everything from antibiotics to diabetes meds. I guess my

former partner did some of this on my days off. Also there is still that

transition going on, the patients are all used to having that

" firewall " of receptionists and nurses to speak to first and are all

shocked when I answer the phone. Its almost like, " I thought I could leave

a message and you would absent mindedly call in a years worth of

oxy-contin " . Anyway, when I tell people I can see them today for

this problem, I get about a third who tell me how incredibly busy they are, it

might be nice to do virtual office visits for a few of them, especially for

things like blood pressure logs or blood sugar logs. Of course those are not

usually the people who don't want to come in. Sorry, got a little wordy

there. I'd love to hear if you have any ideas.

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Guest guest

I personally think you

just have to make them come in. Virtual visits just sound like a set up

to me for a medico-legal meltdown. Face to face visits should be set as

the office standard from day one.

Re:

Virtual Office Visits

How

much do you charge for it ? I find since starting my new office,

I seem to have a lot of patients who are resistant to coming in, they want me

to phone in everything from antibiotics to diabetes meds. I guess my

former partner did some of this on my days off. Also there is still that

transition going on, the patients are all used to having that

" firewall " of receptionists and nurses to speak to first and are all

shocked when I answer the phone. Its almost like, " I thought I could leave

a message and you would absent mindedly call in a years worth of

oxy-contin " . Anyway, when I tell people I can see them today for

this problem, I get about a third who tell me how incredibly busy they are, it

might be nice to do virtual office visits for a few of them, especially for

things like blood pressure logs or blood sugar logs. Of course those are not

usually the people who don't want to come in. Sorry, got a little wordy

there. I'd love to hear if you have any ideas.

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I am not in favor of virtual visits for a variety of reasons.1) Medico-legal (obvious I think)2) Undermines the physician/pt relationship.  There is a limit to how much technology the human brain can wrap itself around.  I think we have a low touch, tech high society and that the human element (psychosocial,emotional, spiritual and physical) get lost in the mix. I think everyone needs to be physically touched and we need eye contact, human contact.3) Ultimately more loss of autonomy for docs.  Believe me, if the ins companies or stakeholders (the folks who have docs lined up on skewers) want us to see 60 patients a day virtually and can figure out a way to mandate it they will.  4) We are not mechanics who are in high production mode.  Physicians are teachers, healers, with a smattering of priesthood like shamans.  Virtual visits will DEGRADE our profession.That's my 2 cents.Just because a fancy  high tech gadget can do 12 things at once does not mean it will improve my life.  When I stand back and look at the big picture I see a world that needs more LOVE (and Low Overhead Volume Employment), more time, more caring, more community, empowerment...  essentially a more human world.  I judge everything against the big picture.PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...  I personally think you just have to make them come in.  Virtual visits just sound like a set up to me for a medico-legal meltdown.  Face to face visits should be set as the office standard from day one.   Re: Virtual Office Visits  How much do you charge for it ?  I find since starting my new office, I seem to have a lot of patients who are resistant to coming in, they want me to phone in everything from antibiotics to diabetes meds. I guess  my former partner did some of this on my days off. Also there is still that transition going on, the patients are all used to having that "firewall" of receptionists and nurses to speak to first and are all shocked when I answer the phone. Its almost like, "I thought I could leave a message and you would absent mindedly call in a years worth of oxy-contin".  Anyway, when I tell people I can see them today for this problem, I get about a third who tell me how incredibly busy they are, it might be nice to do virtual office visits for a few of them, especially for things like blood pressure logs or blood sugar logs. Of course those are not usually the people who don't want to come in.  Sorry, got a little wordy there. I'd love to hear if you have any ideas.  

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I am not in favor of virtual visits for a variety of reasons.1) Medico-legal (obvious I think)2) Undermines the physician/pt relationship.  There is a limit to how much technology the human brain can wrap itself around.  I think we have a low touch, tech high society and that the human element (psychosocial,emotional, spiritual and physical) get lost in the mix. I think everyone needs to be physically touched and we need eye contact, human contact.3) Ultimately more loss of autonomy for docs.  Believe me, if the ins companies or stakeholders (the folks who have docs lined up on skewers) want us to see 60 patients a day virtually and can figure out a way to mandate it they will.  4) We are not mechanics who are in high production mode.  Physicians are teachers, healers, with a smattering of priesthood like shamans.  Virtual visits will DEGRADE our profession.That's my 2 cents.Just because a fancy  high tech gadget can do 12 things at once does not mean it will improve my life.  When I stand back and look at the big picture I see a world that needs more LOVE (and Low Overhead Volume Employment), more time, more caring, more community, empowerment...  essentially a more human world.  I judge everything against the big picture.PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...  I personally think you just have to make them come in.  Virtual visits just sound like a set up to me for a medico-legal meltdown.  Face to face visits should be set as the office standard from day one.   Re: Virtual Office Visits  How much do you charge for it ?  I find since starting my new office, I seem to have a lot of patients who are resistant to coming in, they want me to phone in everything from antibiotics to diabetes meds. I guess  my former partner did some of this on my days off. Also there is still that transition going on, the patients are all used to having that "firewall" of receptionists and nurses to speak to first and are all shocked when I answer the phone. Its almost like, "I thought I could leave a message and you would absent mindedly call in a years worth of oxy-contin".  Anyway, when I tell people I can see them today for this problem, I get about a third who tell me how incredibly busy they are, it might be nice to do virtual office visits for a few of them, especially for things like blood pressure logs or blood sugar logs. Of course those are not usually the people who don't want to come in.  Sorry, got a little wordy there. I'd love to hear if you have any ideas.  

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i agree. patients don't understand or care about our professional responsibilities and risk of liability; they want what they want when they want it. unfortunately, many have been trained by inappropriate doctors and their staff. some can be rehabilitated and retrained with explanations and the simple requirement that treatment requires a face-to-face visit. if they are accepting of that, great, if not, then discharge them to seek care elsewhere. if you are a softie and afraid to offend people, have someone else do it. if you have a medical assistant, have that person be the wall i was initially available to just about everyone who called on the phone; now my assistants screen the calls and schedule the patients; patients are told that i am in with patients and unavailable. my work load is up, and i have more time to do my work. hope that's helpful. LL Brock DO

wrote: I personally think you just have to make them come in. Virtual visits just sound like a set up to me for a medico-legal meltdown. Face to face visits should be set as the office standard from day one. -----Original

Message-----From: [mailto: ] On Behalf Of mkcl6@...Sent: Thursday, March 16, 2006 7:21 AMTo: Subject: Re: Virtual Office Visits How much do you charge for it ? I find since starting my new office, I seem to have a lot of patients who are resistant to coming in, they want me to phone

in everything from antibiotics to diabetes meds. I guess my former partner did some of this on my days off. Also there is still that transition going on, the patients are all used to having that "firewall" of receptionists and nurses to speak to first and are all shocked when I answer the phone. Its almost like, "I thought I could leave a message and you would absent mindedly call in a years worth of oxy-contin". Anyway, when I tell people I can see them today for this problem, I get about a third who tell me how incredibly busy they are, it might be nice to do virtual office visits for a few of them, especially for things like blood pressure logs or blood sugar logs. Of course those are not usually the people who don't want to come in. Sorry, got a little wordy there. I'd love to hear if you have any ideas.

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i agree. patients don't understand or care about our professional responsibilities and risk of liability; they want what they want when they want it. unfortunately, many have been trained by inappropriate doctors and their staff. some can be rehabilitated and retrained with explanations and the simple requirement that treatment requires a face-to-face visit. if they are accepting of that, great, if not, then discharge them to seek care elsewhere. if you are a softie and afraid to offend people, have someone else do it. if you have a medical assistant, have that person be the wall i was initially available to just about everyone who called on the phone; now my assistants screen the calls and schedule the patients; patients are told that i am in with patients and unavailable. my work load is up, and i have more time to do my work. hope that's helpful. LL Brock DO

wrote: I personally think you just have to make them come in. Virtual visits just sound like a set up to me for a medico-legal meltdown. Face to face visits should be set as the office standard from day one. -----Original

Message-----From: [mailto: ] On Behalf Of mkcl6@...Sent: Thursday, March 16, 2006 7:21 AMTo: Subject: Re: Virtual Office Visits How much do you charge for it ? I find since starting my new office, I seem to have a lot of patients who are resistant to coming in, they want me to phone

in everything from antibiotics to diabetes meds. I guess my former partner did some of this on my days off. Also there is still that transition going on, the patients are all used to having that "firewall" of receptionists and nurses to speak to first and are all shocked when I answer the phone. Its almost like, "I thought I could leave a message and you would absent mindedly call in a years worth of oxy-contin". Anyway, when I tell people I can see them today for this problem, I get about a third who tell me how incredibly busy they are, it might be nice to do virtual office visits for a few of them, especially for things like blood pressure logs or blood sugar logs. Of course those are not usually the people who don't want to come in. Sorry, got a little wordy there. I'd love to hear if you have any ideas.

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i agree. patients don't understand or care about our professional responsibilities and risk of liability; they want what they want when they want it. unfortunately, many have been trained by inappropriate doctors and their staff. some can be rehabilitated and retrained with explanations and the simple requirement that treatment requires a face-to-face visit. if they are accepting of that, great, if not, then discharge them to seek care elsewhere. if you are a softie and afraid to offend people, have someone else do it. if you have a medical assistant, have that person be the wall i was initially available to just about everyone who called on the phone; now my assistants screen the calls and schedule the patients; patients are told that i am in with patients and unavailable. my work load is up, and i have more time to do my work. hope that's helpful. LL Brock DO

wrote: I personally think you just have to make them come in. Virtual visits just sound like a set up to me for a medico-legal meltdown. Face to face visits should be set as the office standard from day one. -----Original

Message-----From: [mailto: ] On Behalf Of mkcl6@...Sent: Thursday, March 16, 2006 7:21 AMTo: Subject: Re: Virtual Office Visits How much do you charge for it ? I find since starting my new office, I seem to have a lot of patients who are resistant to coming in, they want me to phone

in everything from antibiotics to diabetes meds. I guess my former partner did some of this on my days off. Also there is still that transition going on, the patients are all used to having that "firewall" of receptionists and nurses to speak to first and are all shocked when I answer the phone. Its almost like, "I thought I could leave a message and you would absent mindedly call in a years worth of oxy-contin". Anyway, when I tell people I can see them today for this problem, I get about a third who tell me how incredibly busy they are, it might be nice to do virtual office visits for a few of them, especially for things like blood pressure logs or blood sugar logs. Of course those are not usually the people who don't want to come in. Sorry, got a little wordy there. I'd love to hear if you have any ideas.

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OK, see here is my problem, I am the queen of avoiding conflict. I now have this practice model so I can do everything myself (I do have one staff person) and I really like to just answer the phone and take care of things right then. The vast majority of the time these things are really easily taken care of by me in a few minutes. Its just those pain in the rear (probably axis 2 people according to my husband) who know how to push all my buttons and don't want to come in. I still make them come in and I don't call their meds in, but I don't like it, it makes me uncomfortable to have these arguments or near arguments with these people I am really just trying to help. One lady actually said to me"cha ching, cha ching, there goes the copay cash register". All because I wouldn't call in her antibiotic for otitis. I feel like I have told my patients I'm starting this new practice because my relationship with them means something and I want to provide a level of care that is less hassle for them and more fulfilling for us both. Most of my patients hated the whole "leave a message" with the nurse thing. Now I feel like I need a person to run defense for some of these patients. I probably just need to get a grip.

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OK, see here is my problem, I am the queen of avoiding conflict. I now have this practice model so I can do everything myself (I do have one staff person) and I really like to just answer the phone and take care of things right then. The vast majority of the time these things are really easily taken care of by me in a few minutes. Its just those pain in the rear (probably axis 2 people according to my husband) who know how to push all my buttons and don't want to come in. I still make them come in and I don't call their meds in, but I don't like it, it makes me uncomfortable to have these arguments or near arguments with these people I am really just trying to help. One lady actually said to me"cha ching, cha ching, there goes the copay cash register". All because I wouldn't call in her antibiotic for otitis. I feel like I have told my patients I'm starting this new practice because my relationship with them means something and I want to provide a level of care that is less hassle for them and more fulfilling for us both. Most of my patients hated the whole "leave a message" with the nurse thing. Now I feel like I need a person to run defense for some of these patients. I probably just need to get a grip.

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: I have avoided the creation of a website because I did not feel it contributed to patient care. On our last conference call with Gordon, it has become clear that this can serve as a good information source to provide information to motivated patient's. I see you use Medfusion. Does it provide the secure e-mail. Do you think you could link appointmentquest, and other resources directly to this website as a single resource. I am trying to have a one stop portal for all communications. Perhaps onebox which has could also be linked for faxes. Eads wrote: These are online visits or electronic ‘e’ visits done through a secure portal. It’s a feature of the Medfusion website (www.pinnaclefamilymedicine.com) I have, and a better way of doing what I’ve been doing since starting this practice 7/03 (before was not as secure). It’s for established pts only, allow

attachments (eg BP/glucose log in excel or word, digital pic of a mole, etc), follows a Mayo based question tree, and is billed under 0074T directly to pts unless they have Kaiser (who is paying for the service for their pts, part of a study they are doing on my practice). Kaiser of Colorado Springs is a different model than the rest of Kaiser – no facility, they use local providers/hosp, etc. If, upon reviewing the patients info, I determine an office visit is indicated to evaluate their condition, I notify them of that, don’t charge them, and have the HPI already done (use the info they submitted) before they reach the door. More info on it @ my website. Virtual Office Visits were one of the

big lectures at the AAFP scientific assembly ( Bachman from Mayo was the lecturer, I believe). Chuck Kilo (an internist in Oregon – Gordon, is that correct?) and contributor to the Future of Family Medicine project is also a big wig in this area. It’s an optional service (people are always welcome to come in for a regular office visit), but I find it useful (although I probably undercharge for it) and the patient’s love the convenience. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863

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: I have avoided the creation of a website because I did not feel it contributed to patient care. On our last conference call with Gordon, it has become clear that this can serve as a good information source to provide information to motivated patient's. I see you use Medfusion. Does it provide the secure e-mail. Do you think you could link appointmentquest, and other resources directly to this website as a single resource. I am trying to have a one stop portal for all communications. Perhaps onebox which has could also be linked for faxes. Eads wrote: These are online visits or electronic ‘e’ visits done through a secure portal. It’s a feature of the Medfusion website (www.pinnaclefamilymedicine.com) I have, and a better way of doing what I’ve been doing since starting this practice 7/03 (before was not as secure). It’s for established pts only, allow

attachments (eg BP/glucose log in excel or word, digital pic of a mole, etc), follows a Mayo based question tree, and is billed under 0074T directly to pts unless they have Kaiser (who is paying for the service for their pts, part of a study they are doing on my practice). Kaiser of Colorado Springs is a different model than the rest of Kaiser – no facility, they use local providers/hosp, etc. If, upon reviewing the patients info, I determine an office visit is indicated to evaluate their condition, I notify them of that, don’t charge them, and have the HPI already done (use the info they submitted) before they reach the door. More info on it @ my website. Virtual Office Visits were one of the

big lectures at the AAFP scientific assembly ( Bachman from Mayo was the lecturer, I believe). Chuck Kilo (an internist in Oregon – Gordon, is that correct?) and contributor to the Future of Family Medicine project is also a big wig in this area. It’s an optional service (people are always welcome to come in for a regular office visit), but I find it useful (although I probably undercharge for it) and the patient’s love the convenience. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863

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: I have avoided the creation of a website because I did not feel it contributed to patient care. On our last conference call with Gordon, it has become clear that this can serve as a good information source to provide information to motivated patient's. I see you use Medfusion. Does it provide the secure e-mail. Do you think you could link appointmentquest, and other resources directly to this website as a single resource. I am trying to have a one stop portal for all communications. Perhaps onebox which has could also be linked for faxes. Eads wrote: These are online visits or electronic ‘e’ visits done through a secure portal. It’s a feature of the Medfusion website (www.pinnaclefamilymedicine.com) I have, and a better way of doing what I’ve been doing since starting this practice 7/03 (before was not as secure). It’s for established pts only, allow

attachments (eg BP/glucose log in excel or word, digital pic of a mole, etc), follows a Mayo based question tree, and is billed under 0074T directly to pts unless they have Kaiser (who is paying for the service for their pts, part of a study they are doing on my practice). Kaiser of Colorado Springs is a different model than the rest of Kaiser – no facility, they use local providers/hosp, etc. If, upon reviewing the patients info, I determine an office visit is indicated to evaluate their condition, I notify them of that, don’t charge them, and have the HPI already done (use the info they submitted) before they reach the door. More info on it @ my website. Virtual Office Visits were one of the

big lectures at the AAFP scientific assembly ( Bachman from Mayo was the lecturer, I believe). Chuck Kilo (an internist in Oregon – Gordon, is that correct?) and contributor to the Future of Family Medicine project is also a big wig in this area. It’s an optional service (people are always welcome to come in for a regular office visit), but I find it useful (although I probably undercharge for it) and the patient’s love the convenience. A. Eads, M.D. Pinnacle Family Medicine, PLLC phone fax P.O. Box 7275 Woodland Park, CO 80863

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The lecturer @ the AAFP SA from Mayo

recommended $10-15 more than a copay. Copays in my area range from

nothing (nice insurance) to $35. I opted for $20 per VOV to get it

started, (getting people used to it). If the VOV has to be aborted (ie,

need to come in), then I don’t charge them – you have the option of

charge/not charge at the end of the encounter.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of mkcl6@...

Sent: Thursday, March 16, 2006

5:21 AM

To:

Subject: Re:

Virtual Office Visits

How much do you charge for it

? I find since starting my new office, I seem to have a lot of

patients who are resistant to coming in, they want me to phone in everything

from antibiotics to diabetes meds. I guess my former partner did some of

this on my days off. Also there is still that transition going on, the patients

are all used to having that " firewall " of receptionists and nurses to

speak to first and are all shocked when I answer the phone. Its almost like,

" I thought I could leave a message and you would absent mindedly call in a

years worth of oxy-contin " . Anyway, when I tell people I can see

them today for this problem, I get about a third who tell me how incredibly

busy they are, it might be nice to do virtual office visits for a few of them,

especially for things like blood pressure logs or blood sugar logs. Of course

those are not usually the people who don't want to come in. Sorry, got a

little wordy there. I'd love to hear if you have any ideas.

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The lecturer @ the AAFP SA from Mayo

recommended $10-15 more than a copay. Copays in my area range from

nothing (nice insurance) to $35. I opted for $20 per VOV to get it

started, (getting people used to it). If the VOV has to be aborted (ie,

need to come in), then I don’t charge them – you have the option of

charge/not charge at the end of the encounter.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of mkcl6@...

Sent: Thursday, March 16, 2006

5:21 AM

To:

Subject: Re:

Virtual Office Visits

How much do you charge for it

? I find since starting my new office, I seem to have a lot of

patients who are resistant to coming in, they want me to phone in everything

from antibiotics to diabetes meds. I guess my former partner did some of

this on my days off. Also there is still that transition going on, the patients

are all used to having that " firewall " of receptionists and nurses to

speak to first and are all shocked when I answer the phone. Its almost like,

" I thought I could leave a message and you would absent mindedly call in a

years worth of oxy-contin " . Anyway, when I tell people I can see

them today for this problem, I get about a third who tell me how incredibly

busy they are, it might be nice to do virtual office visits for a few of them,

especially for things like blood pressure logs or blood sugar logs. Of course

those are not usually the people who don't want to come in. Sorry, got a

little wordy there. I'd love to hear if you have any ideas.

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Guest guest

The lecturer @ the AAFP SA from Mayo

recommended $10-15 more than a copay. Copays in my area range from

nothing (nice insurance) to $35. I opted for $20 per VOV to get it

started, (getting people used to it). If the VOV has to be aborted (ie,

need to come in), then I don’t charge them – you have the option of

charge/not charge at the end of the encounter.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of mkcl6@...

Sent: Thursday, March 16, 2006

5:21 AM

To:

Subject: Re:

Virtual Office Visits

How much do you charge for it

? I find since starting my new office, I seem to have a lot of

patients who are resistant to coming in, they want me to phone in everything

from antibiotics to diabetes meds. I guess my former partner did some of

this on my days off. Also there is still that transition going on, the patients

are all used to having that " firewall " of receptionists and nurses to

speak to first and are all shocked when I answer the phone. Its almost like,

" I thought I could leave a message and you would absent mindedly call in a

years worth of oxy-contin " . Anyway, when I tell people I can see

them today for this problem, I get about a third who tell me how incredibly

busy they are, it might be nice to do virtual office visits for a few of them,

especially for things like blood pressure logs or blood sugar logs. Of course

those are not usually the people who don't want to come in. Sorry, got a

little wordy there. I'd love to hear if you have any ideas.

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Guest guest

I do agree we should not give our

skills/care away for free. I’m similar to your situation in many

ways – like to do things efficiently, and most of my 99212 and 99213’s

are virtual office visits. I would bring in more revenue not doing the

VOV and making every one come in, but that is not my main goal. I want a

comfortable living, enjoy what I am doing, and help people improve their

health.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of mkcl6@...

Sent: Thursday, March 16, 2006

5:34 PM

To:

Subject: Re:

Virtual Office Visits

OK, see here is my problem, I am the

queen of avoiding conflict. I now have this practice model so I can do

everything myself (I do have one staff person) and I really like to just answer

the phone and take care of things right then. The vast majority of the time

these things are really easily taken care of by me in a few minutes. Its just

those pain in the rear (probably axis 2 people according to my husband)

who know how to push all my buttons and don't want to come in. I still make

them come in and I don't call their meds in, but I don't like it, it makes me

uncomfortable to have these arguments or near arguments with these people I am

really just trying to help. One lady actually said to me " cha ching,

cha ching, there goes the copay cash register " . All because I

wouldn't call in her antibiotic for otitis. I feel like I have told my patients

I'm starting this new practice because my relationship with them means

something and I want to provide a level of care that is less hassle for them

and more fulfilling for us both. Most of my patients hated the whole

" leave a message " with the nurse thing. Now I feel like I need a

person to run defense for some of these patients. I probably just need to get a

grip.

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Guest guest

I do agree we should not give our

skills/care away for free. I’m similar to your situation in many

ways – like to do things efficiently, and most of my 99212 and 99213’s

are virtual office visits. I would bring in more revenue not doing the

VOV and making every one come in, but that is not my main goal. I want a

comfortable living, enjoy what I am doing, and help people improve their

health.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of mkcl6@...

Sent: Thursday, March 16, 2006

5:34 PM

To:

Subject: Re:

Virtual Office Visits

OK, see here is my problem, I am the

queen of avoiding conflict. I now have this practice model so I can do

everything myself (I do have one staff person) and I really like to just answer

the phone and take care of things right then. The vast majority of the time

these things are really easily taken care of by me in a few minutes. Its just

those pain in the rear (probably axis 2 people according to my husband)

who know how to push all my buttons and don't want to come in. I still make

them come in and I don't call their meds in, but I don't like it, it makes me

uncomfortable to have these arguments or near arguments with these people I am

really just trying to help. One lady actually said to me " cha ching,

cha ching, there goes the copay cash register " . All because I

wouldn't call in her antibiotic for otitis. I feel like I have told my patients

I'm starting this new practice because my relationship with them means

something and I want to provide a level of care that is less hassle for them

and more fulfilling for us both. Most of my patients hated the whole

" leave a message " with the nurse thing. Now I feel like I need a

person to run defense for some of these patients. I probably just need to get a

grip.

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I do agree we should not give our

skills/care away for free. I’m similar to your situation in many

ways – like to do things efficiently, and most of my 99212 and 99213’s

are virtual office visits. I would bring in more revenue not doing the

VOV and making every one come in, but that is not my main goal. I want a

comfortable living, enjoy what I am doing, and help people improve their

health.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From:

[mailto: ] On

Behalf Of mkcl6@...

Sent: Thursday, March 16, 2006

5:34 PM

To:

Subject: Re:

Virtual Office Visits

OK, see here is my problem, I am the

queen of avoiding conflict. I now have this practice model so I can do

everything myself (I do have one staff person) and I really like to just answer

the phone and take care of things right then. The vast majority of the time

these things are really easily taken care of by me in a few minutes. Its just

those pain in the rear (probably axis 2 people according to my husband)

who know how to push all my buttons and don't want to come in. I still make

them come in and I don't call their meds in, but I don't like it, it makes me

uncomfortable to have these arguments or near arguments with these people I am

really just trying to help. One lady actually said to me " cha ching,

cha ching, there goes the copay cash register " . All because I

wouldn't call in her antibiotic for otitis. I feel like I have told my patients

I'm starting this new practice because my relationship with them means

something and I want to provide a level of care that is less hassle for them

and more fulfilling for us both. Most of my patients hated the whole

" leave a message " with the nurse thing. Now I feel like I need a

person to run defense for some of these patients. I probably just need to get a

grip.

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,Unless you're really desperate for patients, why would you want to keep patients like this? What's worse, they're probably the ones who will be most likely to sue you if something goes wrong. I've learned that even with this open access, high touch practice model, there are some patients who are not going to be happy. If it's either make them happy, or make me happy, I think I'd rather make me happy and select for patients who appreciate what we're giving them. SetoSouth Pasadena, CA OK, see here is my problem, I am the queen of avoiding conflict. I now have this practice model so I can do everything myself (I do have one staff person) and I really like to just answer the phone and take care of things right then. The vast majority of the time these things are really easily taken care of by me in a few minutes. Its just those pain in the rear  (probably axis 2 people according to my husband) who know how to push all my buttons and don't want to come in. I still make them come in and I don't call their meds in, but I don't like it, it makes me uncomfortable to have these arguments or near arguments with these people I am really just trying to help.  One lady actually said to me"cha ching, cha ching, there goes the copay cash register".  All because I wouldn't call in her antibiotic for otitis. I feel like I have told my patients I'm starting this new practice because my relationship with them means something and I want to provide a level of care that is less hassle for them and more fulfilling for us both.  Most of my patients hated the whole "leave a message" with the nurse thing. Now I feel like I need a person to run defense for some of these patients. I probably just need to get a grip. 

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-Do NOT keep patients who are disrespectful to you. I totally agree with !!Take care of yourself first. The rest will follow.PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...On Mar 16, 2006, at 4:47 PM, Seto wrote: ,Unless you're really desperate for patients, why would you want to keep patients like this? What's worse, they're probably the ones who will be most likely to sue you if something goes wrong. I've learned that even with this open access, high touch practice model, there are some patients who are not going to be happy. If it's either make them happy, or make me happy, I think I'd rather make me happy and select for patients who appreciate what we're giving them. SetoSouth Pasadena, CA OK, see here is my problem, I am the queen of avoiding conflict. I now have this practice model so I can do everything myself (I do have one staff person) and I really like to just answer the phone and take care of things right then. The vast majority of the time these things are really easily taken care of by me in a few minutes. Its just those pain in the rear  (probably axis 2 people according to my husband) who know how to push all my buttons and don't want to come in. I still make them come in and I don't call their meds in, but I don't like it, it makes me uncomfortable to have these arguments or near arguments with these people I am really just trying to help.  One lady actually said to me"cha ching, cha ching, there goes the copay cash register".  All because I wouldn't call in her antibiotic for otitis. I feel like I have told my patients I'm starting this new practice because my relationship with them means something and I want to provide a level of care that is less hassle for them and more fulfilling for us both.  Most of my patients hated the whole "leave a message" with the nurse thing. Now I feel like I need a person to run defense for some of these patients. I probably just need to get a grip. 

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-Do NOT keep patients who are disrespectful to you. I totally agree with !!Take care of yourself first. The rest will follow.PamelaPamela Wible, MDFamily & Community Medicine, LLC3575 st. #220 Eugene, OR 97405roxywible@...On Mar 16, 2006, at 4:47 PM, Seto wrote: ,Unless you're really desperate for patients, why would you want to keep patients like this? What's worse, they're probably the ones who will be most likely to sue you if something goes wrong. I've learned that even with this open access, high touch practice model, there are some patients who are not going to be happy. If it's either make them happy, or make me happy, I think I'd rather make me happy and select for patients who appreciate what we're giving them. SetoSouth Pasadena, CA OK, see here is my problem, I am the queen of avoiding conflict. I now have this practice model so I can do everything myself (I do have one staff person) and I really like to just answer the phone and take care of things right then. The vast majority of the time these things are really easily taken care of by me in a few minutes. Its just those pain in the rear  (probably axis 2 people according to my husband) who know how to push all my buttons and don't want to come in. I still make them come in and I don't call their meds in, but I don't like it, it makes me uncomfortable to have these arguments or near arguments with these people I am really just trying to help.  One lady actually said to me"cha ching, cha ching, there goes the copay cash register".  All because I wouldn't call in her antibiotic for otitis. I feel like I have told my patients I'm starting this new practice because my relationship with them means something and I want to provide a level of care that is less hassle for them and more fulfilling for us both.  Most of my patients hated the whole "leave a message" with the nurse thing. Now I feel like I need a person to run defense for some of these patients. I probably just need to get a grip. 

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I prefer to avoid

conflict too, but if it comes to that I simply say, in a calm, quiet,

respectful tone: “You should

choose a doctor whose services you value enough to pay for them. I will have your records ready to send

to whomever you choose. Good-bye.” No further conflict.

Annie

Re:

Virtual Office Visits

OK, see

here is my problem, I am the queen of avoiding conflict. I now have this

practice model so I can do everything myself (I do have one staff person) and I

really like to just answer the phone and take care of things right then. The

vast majority of the time these things are really easily taken care of by me in

a few minutes. Its just those pain in the rear (probably axis 2 people

according to my husband) who know how to push all my buttons and don't want to

come in. I still make them come in and I don't call their meds in, but I don't

like it, it makes me uncomfortable to have these arguments or near arguments

with these people I am really just trying to help. One lady actually said

to me " cha ching, cha ching, there goes the copay cash register " .

All because I wouldn't call in her antibiotic for otitis. I feel like I have

told my patients I'm starting this new practice because my relationship with

them means something and I want to provide a level of care that is less hassle

for them and more fulfilling for us both. Most of my patients hated the

whole " leave a message " with the nurse thing. Now I feel like I need

a person to run defense for some of these patients. I probably just need to get

a grip.

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So you are charging cash only for VOV?

Re:

Virtual Office Visits

How much

do you charge for it ? I find since starting my new office, I

seem to have a lot of patients who are resistant to coming in, they want me to

phone in everything from antibiotics to diabetes meds. I guess my former

partner did some of this on my days off. Also there is still that transition

going on, the patients are all used to having that " firewall " of

receptionists and nurses to speak to first and are all shocked when I answer

the phone. Its almost like, " I thought I could leave a message and you

would absent mindedly call in a years worth of oxy-contin " . Anyway,

when I tell people I can see them today for this problem, I get about a third

who tell me how incredibly busy they are, it might be nice to do virtual office

visits for a few of them, especially for things like blood pressure logs or

blood sugar logs. Of course those are not usually the people who don't want to

come in. Sorry, got a little wordy there. I'd love to hear if you have

any ideas.

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