Re: procedures and also email please

[Guest guest]

I do not do any of those procedures you mentioned: too much time, would raise my

malpractice, local standard of care dictates otherwise (specialists generally do

these things). I do not use e-mail for any patients at all.

>

>

> Date: 2007/02/18 Sun PM 02:09:15 EST

> To: " 'practiceimprovement1 ' "

> <practiceimprovement1 >

> Subject: procedures and also email please

>

> Hi s till would like to know who of you any? doing colonscopies egds

> sigmoids and/or OB ? Vasectomies?

>

> For me to be able to repsond to some folks i met last week thank you.

>

>

>

>

> ALSO so, now i email patietns . Oh god it is nice convenenit fast etc

> But of course I now realize even if they are only making an

> appointmetn-unless ALL they say is can you see me and I say yes 3 pm--

> otherwise if they tell me ANYTHING clinical " Katelyn has draining ears

> has not had this since X " etc I had better save that to the chart or at

> least somewhere huh? I guess i could re take that history and make sure it

> is in the note..What do others do?

> Sometimes i cut and paset when lazy i just stick these in a folder

> called patietn e emails.

> Ideas??

>

> You know, about a year ago cut and paste actcually meant scissors and

> scotch tape

>

> Thank you

>

>

[Guest guest]

Hi

None of those procedures

for me. I do skin stuff and some joint

injections, but not much else. I

know HOW to do colonoscopies, and got pretty good at it in a month long

elective during residency (did about 65 of them), but logistics not favorable to

do them now (can’t afford to buy the scope, Sterix,

light source, etc, etc, etc) and besides, you can’t do that with

monitoring and IV sedation ALL BY YOURSELF. Gotta

have staff for that and it probably has to be RN.

I was going to buy a treadmill to do

stress tests in the office, but when I found out that my medmal

would go up by $10K per year, and I would only be paid about $85 per test,

meaning the first 117 I did would go to pay the medmal,

the next 23 would go to pay for the treadmill and software….Well I would

have to do 140 of them a year to break even (meaning pay the cost of being able

to do them, but not paying me ANYTHING for my work to do them). So, obviously, I had to conclude that I

couldn’t do them. Too bad,

because at $85 a pop in appropriately selected patients, the plain old GXT is

pretty good bang for the healthcare buck, but at least where I am, the

community standard is now to go straight to a nuclear test, at a cost (I’m

told) of over $1400 by the time you add in the hospital cost on top of the

cardiologist’s fee, cost of the tracer etc…

As for OB, even worse medmal situation, and there are 12 OB docs at my location

anyway; and 6 urologists, so no vasectomies either…

ON EMAIL, did you sign up with some sort

of HIPPA compliant, secure outfit to be able to do that? People can email me from my website, but I

have a disclaimer on there that it is not secure, and they should not send any

sensitive information that way….The email account is not Yahoo, but neither

is it encrypted or whatever makes email “secure”. I was just trying to get set

up on HYH and DocSite, and saw that secure email will

be required for that, but don’t really know how I’ll handle that….

Annie

procedures and also email please

Hi s till would like to know who of you any? doing

colonscopies egds

sigmoids and/or OB ? Vasectomies?

For me to be able to repsond to some folks i met last week thank you.

ALSO so, now i email patietns . Oh god it is nice convenenit fast etc

But of course I now realize even if they are only making an

appointmetn-unless ALL they say is can you see me and I say yes 3 pm--

otherwise if they tell me ANYTHING clinical " Katelyn has draining ears

has not had this since X " etc I had better save that to the chart or at

least somewhere huh? I guess i could re take that history and make sure it

is in the note..What do others do?

Sometimes i cut and paset when lazy i just stick these in a folder

called patietn e emails.

Ideas??

You know, about a year ago cut and paste actcually meant scissors and

scotch tape

Thank you

[Guest guest]

I don’t do procedures, except

freezing minor skin stuff.

Emails – they are automatically

saved to my pts charts. For those (couples) that share the same email

address (despite my encouragement to have separate email accounts), I copy and

paste the note in to the correct pts chart, as a ‘chartnote’ entry.

A. Eads, M.D.

Pinnacle Family Medicine, PLLC

phone fax

P.O.

Box 7275

Woodland

Park, CO 80863

From: [mailto: ] On Behalf Of

Sent: Sunday, February 18, 2007

12:09 PM

To:

'practiceimprovement1 '

Subject:

procedures and also email please

Hi s till

would like to know who of you any? doing colonscopies egds

sigmoids and/or OB ? Vasectomies?

For me to be able to repsond to some folks i met last week thank you.

ALSO so, now i email patietns . Oh god it is nice convenenit fast etc

But of course I now realize even if they are only making an

appointmetn-unless ALL they say is can you see me and I say yes 3 pm--

otherwise if they tell me ANYTHING clinical " Katelyn has draining ears

has not had this since X " etc I had better save that to the chart or at

least somewhere huh? I guess i could re take that history and make sure it

is in the note..What do others do?

Sometimes i cut and paset when lazy i just stick these in a folder

called patietn e emails.

Ideas??

You know, about a year ago cut and paste actcually meant scissors and

scotch tape

Thank you

[Guest guest]

Colonoscopies: 50/yr.OB: 60/yr.Vas: 20/yr.Email: about 10 patients use it, mainly my patients who are night nurses.The Midwife working with me on the IMP practice also does about 30 deliveries/yr.Ben Brewer MD

8:00? 8:25? 8:40? Find a flick in no time with theYahoo! Search movie showtime shortcut.

[Guest guest]

I am starting up an IMP in July.

I haven’t done OB

in 24 years, will not do colonoscopies, and gave up flex sigs years ago. I

will probably be doing straight sigs and anoscopes, mainly just to visualize

hemorrhoids (I like to band hemorrhoids). I do a couple of vasectomies

every month, and will probably continue, since I get a reasonable number of

referrals for them. At a half-time rate, discounted for first year in practice

with this insurer, just one vasectomy in a year will cover the extra malpractice

I will have to pay.

I email patients all the time. All

lab reports go by email. I copy and paste the emails from patients into

the chart, and I create letters in my EMR for lab and other reports, and then

just email them to the patients.

When I go live in July, I intend to give

my patients 24/7 secure access to their charts via the internet, and all

messaging will be directly through the portal into the EMR, so the only emails

then will be to notify the patients to go to the web portal.

T. , MD

Soon to be Sammamish Diabetes and Lipid

Clinic

From: [mailto: ] On Behalf Of

Sent: Sunday, February 18, 2007

11:09 AM

To:

'practiceimprovement1 '

Subject:

procedures and also email please

Hi s till

would like to know who of you any? doing colonscopies egds

sigmoids and/or OB ? Vasectomies?

For me to be able to repsond to some folks i met last week thank you.

ALSO so, now i email patietns . Oh god it is nice convenenit fast etc

But of course I now realize even if they are only making an

appointmetn-unless ALL they say is can you see me and I say yes 3 pm--

otherwise if they tell me ANYTHING clinical " Katelyn has draining ears

has not had this since X " etc I had better save that to the chart or at

least somewhere huh? I guess i could re take that history and make sure it

is in the note..What do others do?

Sometimes i cut and paset when lazy i just stick these in a folder

called patietn e emails.

Ideas??

You know, about a year ago cut and paste actcually meant scissors and

scotch tape

Thank you

[Guest guest]

I am curious: what EHR are you going to use that allows you in-chart

email messaging?

Marius

>

> I am starting up an IMP in July.

>

>

>

> I haven't done OB in 24 years, will not do colonoscopies, and gave

up flex

> sigs years ago. I will probably be doing straight sigs and

anoscopes,

> mainly just to visualize hemorrhoids (I like to band

hemorrhoids). I do a

> couple of vasectomies every month, and will probably continue,

since I get

> a reasonable number of referrals for them. At a half-time rate,

discounted

> for first year in practice with this insurer, just one vasectomy

in a year

> will cover the extra malpractice I will have to pay.

>

>

>

> I email patients all the time. All lab reports go by email. I

copy and

> paste the emails from patients into the chart, and I create

letters in my

> EMR for lab and other reports, and then just email them to the

patients.

>

>

>

> When I go live in July, I intend to give my patients 24/7 secure

access to

> their charts via the internet, and all messaging will be directly

through

> the portal into the EMR, so the only emails then will be to notify

the

> patients to go to the web portal.

>

>

>

> T. , MD

>

> Soon to be Sammamish Diabetes and Lipid Clinic

>

>

>

> _____

>

> From:

> [mailto: ] On Behalf Of Jean

Antonucci

> Sent: Sunday, February 18, 2007 11:09 AM

> To: 'practiceimprovement1 '

> Subject: procedures and also email please

>

>

>

> Hi s till would like to know who of you any? doing colonscopies

egds

> sigmoids and/or OB ? Vasectomies?

>

> For me to be able to repsond to some folks i met last week thank

you.

>

> ALSO so, now i email patietns . Oh god it is nice convenenit fast

etc

> But of course I now realize even if they are only making an

> appointmetn-unless ALL they say is can you see me and I say yes 3

pm--

> otherwise if they tell me ANYTHING clinical " Katelyn has draining

ears

> has not had this since X " etc I had better save that to the chart

or at

> least somewhere huh? I guess i could re take that history and make

sure it

> is in the note..What do others do?

> Sometimes i cut and paset when lazy i just stick these in a folder

> called patietn e emails.

> Ideas??

>

> You know, about a year ago cut and paste actcually meant scissors

and

> scotch tape

>

> Thank you

>

[Guest guest]

Ben,

I am thinking about opening an IMP practice with similar procedures.

What do you pay for malpractice?

Mike

>

>

>

> Colonoscopies: 50/yr.

> OB: 60/yr.

> Vas: 20/yr.

> Email: about 10 patients use it, mainly my patients who are night

nurses.

> The Midwife working with me on the IMP practice also does about 30

deliveries/yr.

>

> Ben Brewer MD

>

>

>

>

>

>

>

>

>

>

______________________________________________________________________

______________

> Need Mail bonding?

> Go to the Yahoo! Mail Q & A for great tips from Yahoo! Answers users.

> http://answers.yahoo.com/dir/?link=list & sid=396546091

>

[Guest guest]

Ben,

I am thinking about opening an IMP practice with similar procedures.

What do you pay for malpractice?

Mike

>

>

>

> Colonoscopies: 50/yr.

> OB: 60/yr.

> Vas: 20/yr.

> Email: about 10 patients use it, mainly my patients who are night

nurses.

> The Midwife working with me on the IMP practice also does about 30

deliveries/yr.

>

> Ben Brewer MD

>

>

>

>

>

>

>

>

>

>

______________________________________________________________________

______________

> Need Mail bonding?

> Go to the Yahoo! Mail Q & A for great tips from Yahoo! Answers users.

> http://answers.yahoo.com/dir/?link=list & sid=396546091

>