What happens
when your
family doctor
orders
LAB TESTS
for you?
Another 🧵 about the inner workings of 🇨🇦 primary care (or how the sausage gets made), and how fixing the #familydoctorshortage is not just about hiring more doctors.
Let's say you go to your doctor,
after considering your story (= reason for your visit), your past medical history,
the possible diagnoses/treatments
for the issue,
she decides to order blood work (=evidence-based medicine),
& you agree with that (=shared decision making).
She creates a LAB REQUISITION (="req")
She selects the tests that she thinks will help understand/treat/monitor the issue.
This is based on what she learned in med school, what she learned staying up to date(=Continuing Medical Education) & sometimes, a specialist's advice
I am a generalist,
full-service family doctor,
working in a clinic
that provides
longitudinal primary care,
and I referred
a few patients
to specialists
this week...
-the reason they needed the appointment today
-how life is going in general
-as needed, their other medical history
after I get hear the story
do a physical exam
review old information
We may decide that we need extra advice 2/9
Sometimes it is:
to confirm the diagnosis or
change treatment or
decide on tests or imaging
consider surgery
etc
I need to formulate a specific question & summarize the patient's condition, history and preferences. I do this both on the fly & after the appointment. 3/9
Our MDs and NPs are on call for one week at a time.
Between 5pm-8am weekdays and all weekend,
we need to be ready to
support patients for
URGENT, not emergency issues
that cannot wait until the next business day
that means phone close by at all times
People call appropriately for:
e.g. sick baby with fever, to figure out does she need to go to emergency or can stay home
or
e.g. strained back shoveling snow and want to know what can do to alleviate pain
I can bill a "telehealth visit: 14x37"
~32$ for call + documentation
❗️cleaning data in your emr
❗️attending evening meetings about new fee codes &how to increase billing’s
❗️order the right amount of flu vaccine
❗️know all the non profit support services to refer your patients too in the lower mainland
❗️store &archive charts forever