advice please sports pe on pts you will never see again

[pedspnp]

Ok I have been at my new job for a month, I work in a rural clinic that is not a walk in clinic. 3 time this week I have seen patients that are only coming in for a sports physical because their current provider can not see them in time for the sports physical which they have known for months needed to be done. My problem with this is I do not have their medical history to go by, I have to rely on what they tell me and what they put on the form and the history can be sketchy . I talk to the familys about having a medical home and why they should go to see their primary for these types of physical. I know that minute clinics do this type of thing but my concern is what if they were not forth coming or did not remember something important and something should happen where is my liability. I am thinking of talking to the office manager and scheduling tomorrow about these types of appts and ask too not book them or am i being to stringent in who I see:crying2:

[BCgradnurse, MSN, RN, NP]

We will not treat patients at my health center who are a "one shot deal". At least not knowingly, anyway. We always ask if they are transferring care to our center, and will direct them elsewhere if they are not. I think these patients should see their primary. I personally am not comfortable with the idea of someone who has never seen my kids clearing them for sports. What if the parents/child are not forthcoming with info and something happens to the child? Who is liable then? It's also a lot of time spent gathering a medical history from and evaluating someone you'll never see again....doesn't seem economically feasible to me, but that depends on insurance and reimbursement, I guess. I would say no to these patients if I could.

[akoster]

we see sports physicals all the time that are never seen again and have no doctor, they are not full on preventative visits, most of these kids only see the doctor when they are sick because the majority of them are healthy and the only visits they get are sports physicals each year, they are meant to be an abbreviated physical, there is a questionnaire on the form for past medical history. If they check off "yes" on the form or there is a past medical history that is noted of concern then I will not sign the form and they will have to schedule an appt. If I find a physical finding that is concerning dont sign the form and refer I do ask more pointed questions like family history of early cardiac problems and such. No visit is foolproof whether sports physicals or regular physicals, there is no visit that is liablity free. you can only go on what the patients or parents tell you about history. We do these all the time in urgent care before sports start, on the flip side I see doctors/ providers going to the schools for "quick" sports physicals. At least in the office I can booster a vaccine if needed.