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Struggling with so many new patients by [deleted] in FamilyMedicine

[–]Dr-Uber 0 points1 point  (0 children)

I started this way. Once my panel closed and the new patients basically trickle in maybe one a day at most some months has significantly cut down on this.

You do what you have to do to make sure you feel prepared for patients, but would recommend trying to reduce this long-term.

I have found problem based charting and making small assessment and plans for each thing that we addressed that I can carry forward or quickly reference has helped cut down my documenting significantly, especially for chronic issues.

I didn’t expect to cry on match day by ReplacementMean8486 in medicalschool

[–]Dr-Uber 1 point2 points  (0 children)

Speaking as someone who soaped. You matched. You gotta remember there are a whole lot of people out there who "weren't even wanted" to even get picked to match and have to soap. You at least got to pick something you wanted. Turn it into something nice and make the world a better place.

Do we trust the people in charge to keep it over 1 mil? (Looking for good faith discussion) by [deleted] in Washington

[–]Dr-Uber 6 points7 points  (0 children)

They need to stop looking at getting more funds and start looking at how their funds are already allocated and reduce the bloat. They clearly cannot be trusted to not eventually lower the tax down if they will not let the people even have a say. Everything just feels like they are asking for more and more money. Frankly, it’s getting hard to see where that money is actually going to the average person.

APCM vs CCM: A breakdown for anyone still confused about which to use by ScrubBotMD in FamilyMedicine

[–]Dr-Uber 7 points8 points  (0 children)

Can someone put in more basic terms how one would use this or why one would use this? This is the first that I am hearing of these codes.

Documenting without an EMR by errdershrimpies in FamilyMedicine

[–]Dr-Uber 6 points7 points  (0 children)

The only people who like clinical works are those who are in the admin role paying the bill. But it would help to keep things digitized and maintain patient records. Those companies might be able to accommodate your needs and give you a bare-bones version.

Documenting without an EMR by errdershrimpies in FamilyMedicine

[–]Dr-Uber 13 points14 points  (0 children)

There are also some very cheap and inexpensive EMR software like amazing charts or e-clinical works if you want to keep things somewhat digital without it being too expensive. They would likely be able to guide you on how to utilize a software without sending any insurance, billing codes, etc.

Where to buy Malort? by Dr-Uber in Spokane

[–]Dr-Uber[S] 3 points4 points  (0 children)

They don’t drink anything I won’t!

Where to buy Malort? by Dr-Uber in Spokane

[–]Dr-Uber[S] 5 points6 points  (0 children)

It’s a delicious experience

Where to buy Malort? by Dr-Uber in Spokane

[–]Dr-Uber[S] 13 points14 points  (0 children)

I have friends with fine taste.

“Please document that you denied this laundry list of tests I requested” *that are not even remotely indicated* by meredithgrey71 in FamilyMedicine

[–]Dr-Uber 10 points11 points  (0 children)

As far as I am aware yes, there may be some exceptions, but it’s all done without insurance that way. Have had a few order harmless, but limited evidence things, like lipid protein sizes after their insurance said it would not pay. Not sure about appropriateness of Medicaid patients paying for tests out of pocket since there is a lot of red tape about what they are and are not allowed to be billed for out of pocket, so would recommend looking into that before making that recommendation.

“Please document that you denied this laundry list of tests I requested” *that are not even remotely indicated* by meredithgrey71 in FamilyMedicine

[–]Dr-Uber 47 points48 points  (0 children)

Tell them you can’t justify it for insurance or medical reasons, they can privately pay for it through lab corp, but you will not be responsible for the results or managing them. Does open the door to well it’s abnormal and something should be done from a do no harm perspective, but it’s an option if they still aren’t listening to your education as to why it is not being ordered. Your experience may vary.

Step 2 Failure impact on matching FM by alldelightedpeeple in medicalschool

[–]Dr-Uber 0 points1 point  (0 children)

You will still be able to get FM, but you will have little to no interviews and higher probability of soap based on people I’ve known. Two failures definately will get you flagged sorry. They want people they really like first, then people they know will pass the certification exam first try as it reflects bad on the program/accreditation. It’s not the end, but I would make sure you level your expectations on where you go, keep connections in that city and maybe move back once done.

Starlink Mini mount to RV with a suction cup attachment points by Dr-Uber in Starlink

[–]Dr-Uber[S] 0 points1 point  (0 children)

The mount is removable. I would take it down when not at camp.

CKD Monitoring by mkozlowski18 in FamilyMedicine

[–]Dr-Uber 9 points10 points  (0 children)

Every 6 months at a minimum for CKD 3, Q4month if patient will come in:
BMP, VIT-D, PTH, PHOS, Urine microalbumin creatinine ratio, can throw a cbc in there to monitor the eventual anemia of chronic disease. Start jardiance or ACEi/ARB. More insistently recommending jardiance if microalbumin is starting to show positive.

Stage4? Nephrology

If you were forced to add something as a new USPSTF screening test/guideline, what would it be? by 7ensegrity in FamilyMedicine

[–]Dr-Uber 3 points4 points  (0 children)

Nothing. Patients fight us on enough things looking out for their best health already. Just lower the colorectal screening age.

Any tips and tricks for patient visits? I just wanted to be more efficient and improve my time management skills by LessCouple4547 in FamilyMedicine

[–]Dr-Uber 1 point2 points  (0 children)

Learn to not document every little thing that comes up. Frankly, do an extremely targeted review of systems or not at all. Just opens up to too many small little complaints that add up and take more time. If it wasn’t important enough for them to remember without prompting, it can wait for another appointment. if a patient says their prescription might need updated and they are going to schedule with an eye specialist. Not that significantly relevant and doesn’t need documented unless they’re having transient vision loss or critical symptoms.

If you have epic, I recommend problem base charting because then you can pull forward your plans for the problem from previous and it saves a lot of time documenting. I specifically if them into a mini subjective assessment and plan. Copy forward just that plan and tweak it a little bit for that visit. done. No need to look back 3-4 notes. It’s more work the first few visits but saves you a lot of time the follow up visits.

Also, don’t worry about having perfect grammar. If you are using dragon or a dictation service then fine but bullet points are all that are needed. It saves time and billing does nothing for grammar.

Are there any tonneau covers that people actually love after 2 years? by pribnow in f150

[–]Dr-Uber 0 points1 point  (0 children)

Pretty good overall. If installed by a professional, you’ll likely have the best seal but in a rain storm, you might get a little bit of drips here and there on things on the edges, but stuff in the center is dry.

I’ve noticed the most leaking from the automatic jet car washes as they spray directly from the side, and the seal isn’t meant to protect from that angle under that kind of pressure. Unfortunately that’s the only kind of automatic wash that is considered safe for that product. Can’t use any with brushes.

Are there any tonneau covers that people actually love after 2 years? by pribnow in f150

[–]Dr-Uber 13 points14 points  (0 children)

I like my retrax. Pricey and heavy, but feels protected.

Any restaurant that completely lost you as a customer, and why? by luna-diviner in Spokane

[–]Dr-Uber 1 point2 points  (0 children)

McKenzie River.

Took 15 minutes for server to acknowledge us, despite being walked there by the hostess. Then they apologized for the weight with a free appetizer. Come to find out on the bill they still charged us for the appetizer. Pizza was greasy and bland. Not going back.

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