Articles like this are so infuriating!

mclennan, BSN, RN · Feb 3, 2015

House Call Doctor : Why Is My Doctor Always Late? :: Quick and Dirty Tips Ã¢Â„Â¢
If dummy Dr. Tardy took a pay cut to hire a good CM RN he'd be on time, have better patient outcomes and recoup the cost with better audits and reimbursement!!!!! DUH!!!

Any case managers agree with this? Hello????

Libby1987 · Feb 5, 2015

How would a CM ensure everyone arrives punctually and doesn't save questions/symptoms until the end of their 10 minutes?

It seems that you would have to manage every patient in the practice rather than just the complex and /or target diagnoses.

mclennan, BSN, RN · Feb 5, 2015

But you don't think a CM might help....just a little......with the many issues brought up on this doctor's timeline?

elkpark · Feb 5, 2015

I don't really see that ...

mclennan, BSN, RN · Feb 6, 2015

Wow. Okay. All the problems this doctor listed are problems I've addressed as a CM for 8 years now.

SummerGarden, BSN, MSN, RN · Feb 6, 2015

Just to add to the conversation, OP, there are MDs in private practices that have RN Case Managers do what you have described. One of my co-workers (she works per diem) has a full-time job working in private practice. Also, I see job postings all the time for private practice CMs to include the ones attached to specific specialties (high risk OB, Nephrology, Cardiology, etc) so I agree, a CM can assist MDs with his/her practice. Plus, there are MDs that know that it behooves his/her practice to also hire a licensed MSW. :)

Libby1987 · Feb 6, 2015

But you don't think a CM might help....just a little......with the many issues brought up on this doctor's timeline?

Oh I definitely think it would help, but the list would be endless, some of these people who cause delays aren't complex or you don't realize it until they lay a big one on the dr. I know a CM could catch some but I don't know if enough to keep a dr from getting behind.

SummerGarden, BSN, MSN, RN · Feb 6, 2015

Oh I definitely think it would help, but the list would be endless, some of these people who cause delays aren't complex or you don't realize it until they lay a big one on the dr. I know a CM could catch some but I don't know if enough to keep a dr from getting behind.

It is not about the CM or MSWs catching everything prior to visits, although that would help. In cases where the patient lays a complicated situation on the doctor during the visit, the MD can then immediately refer the patient to the in-house CM and/or MSW so he/she can now move on to the next patient. If the CM or MSW needs orders for whatever later, either of them can get the orders from the doctor in-between his visit with another patient (It takes two seconds if the orders is already written out to be signed or submitted electronically for e-signature). Which is why this model is being adopted by private practices and outpatient settings all around the country. Plus, it also helps that the ACA is recommending it as an efficient and cost effective way to promote healthy outcomes that are medically backed and based upon evidence based practices.

SHGR, MSN, RN, CNS · Feb 8, 2015

It's ridiculous to think that an office would have all 20 minute appointments for everything including a patient new to the clinic and a new CVA (these would be longer appts in our office).

I can see many ways this whole office setup could run better, including a standing order for a UA on patients with urinary symptoms to having a CM/MSW type person in house (we have three total) for situations like patients with suicidal ideations, and having a nurse triage patients who call with any concerning symptoms. But ultimately, when both the doctor and the patient think the doctor has to do it all (including the diabetes education, including the smoking cessation, including the psychiatric counseling and care) there will simply not be enough time in any day.

So yes, I agree with the OP in the sense that the whole team needs to work up to the highest level that they can, and embedded care coordination is really a good thing.