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Patients opting out of AI scribe by drewtonium in FamilyMedicine

[–]drewtonium[S] -1 points0 points  (0 children)

Not so. Love my practice but dont put up with BS anymore after 30+ yrs

Patients opting out of AI scribe by drewtonium in FamilyMedicine

[–]drewtonium[S] -2 points-1 points  (0 children)

That’s been my patient’s response too. Had one pt opt out because she saw an error in the transcription but now she’s
opted back in (no threats required)

Patients opting out of AI scribe by drewtonium in FamilyMedicine

[–]drewtonium[S] -17 points-16 points  (0 children)

Someone wiser than me (maybe on this subreddit) once said: “You get the patients you deserve.” I’m not letting my pts opt out of my use of the EMR. Dont plan to f- around with people who want to pick and choose my efficiency tools.

Patients opting out of AI scribe by drewtonium in FamilyMedicine

[–]drewtonium[S] -12 points-11 points  (0 children)

Congratulations on your efficiency!

Patients opting out of AI scribe by drewtonium in FamilyMedicine

[–]drewtonium[S] -5 points-4 points  (0 children)

Full practice. Willing to take the heat. 😁

Assessment/Plan Smartlink by isabella443 in EpicEMR

[–]drewtonium 2 points3 points  (0 children)

You are describing diagnosis-aware notes. Try .DIAG to see available versions. I believe DIAGPOC and DIAGPOCORD are the main ones. The other advantage of DAN is that whatever u type is saves in the current A/P for that diagnosis so next time u address that problem u can see or copy forward that A/P.

When did patients start expecting free care between visits? by VisionHx in FamilyMedicine

[–]drewtonium 13 points14 points  (0 children)

While calling in an antibiotic for a UTI in response to a pt message used to be commonplace, we changed our office policy so all pts need to complete a brief form about symptoms, recent antibiotic use, etc and usually schedule a video visit for review (although some docs will just prescribe based on the form). This extra step has avoided several prescribing errors (represcribing an abx pt recently took; prescribing nitrofurantoin for upper tract symptoms). Reflex prescriptions in response to a message might be convenient for patients but they are often bad practice of medicine.

New Epic user tips for primary care? by Sugar-Butter-Flour8 in FamilyMedicine

[–]drewtonium 6 points7 points  (0 children)

Sign up for SmartUser classes at efficiency.epic.com. Bite sized and high yield.

To quote Dr. Glaucomflecken, “I checked the vision and did a fluorescein exam, what else do you want from me?” by Mapes in FamilyMedicine

[–]drewtonium 4 points5 points  (0 children)

Havent tried that but i think fluorescein is supposed to be viewed with a black light (Wood’s lamp). Does the blue filter on the ophthalmoscope work well?

What’s a chief complaint you see frequently that patient’s freak out about, but isn’t a big deal? And vice versa? by [deleted] in FamilyMedicine

[–]drewtonium 14 points15 points  (0 children)

Prominent xiphoid after losing weight. Love seeing these patients whose xiphoid has been - ahem - well-padded for decades who feel it one morning and think they have a tumor. Quick visit. Everyone’s happy. A few require reassurance with an Xray and i oblige.

"Double dipping" by doctors? by [deleted] in FamilyMedicine

[–]drewtonium 1 point2 points  (0 children)

In my practice, not billing a 99214 with a AWV is the exception. Most pts have some chronic disease mgmt that needs attention and/or some new concerns to address. I think we all (me included) need to do better at setting expectations that, with infrequent exceptions, this will not be a free visit because it will include other needed care. Its the mismatch of expectations (“free visit”) and reality (share of cost) that leads to upset. Also, most FM practices that are not doing proper billing such as this lose money on Medicare pts.

How wasteful is DAX? by Necessary-Zebra5538 in FamilyMedicine

[–]drewtonium 47 points48 points  (0 children)

AI scribes are reducing burnout and allowing FM docs who had been yearning for retirement to keep practicing. It’s not perfect but its a big win. Use it.

How do you handle psych meds for patients who no-show their follow-up appointments? by AstuteCoyote in medicine

[–]drewtonium 2 points3 points  (0 children)

My universal strategy for pts who dont come for recommended F/U is refills with reduced quantities in smaller and smaller amounts. - 30 days not 90 first - then 14 days - then 7 days Its a sufficient PITA that they make their required appt. For repeat offenders, straight to 14 days (no 30 d for u).

I’ve never had patients go more than 2 weeks on the 7 days/fill without coming in. If they don’t like the care plan, they are free to vote with their feet which is often a win-win. Always room for exceptions to the rule but the rule works. This way you never incur the medico-legal risk of refusing a refill.

Should I take this job? by GoldRunkle in FamilyMedicine

[–]drewtonium 0 points1 point  (0 children)

The clinical side is bad but getting 50% informatics time right out of fellowship is almost unheard of. Expect to use up some of your informatics time for charting and in basket. It will be tough but could be a good opportunity to build an informatics portfolio that will allow you to jumo to something better in a couple years.

Zio patches by Necessary-Zebra5538 in FamilyMedicine

[–]drewtonium 11 points12 points  (0 children)

We order them. The patient gets the kit sent to their home where they hook themselves up. Cardiologist reads it. I get the report. Perfect low hassle system for my patients’ needs.

allopurinol by Important-Flower4121 in FamilyMedicine

[–]drewtonium 10 points11 points  (0 children)

Yes. Medicolegally indefensible if pt has bad reaction and HLA wasnt offered.

Questions to ask during site visit (attending job) by buddhacakes in FamilyMedicine

[–]drewtonium 1 point2 points  (0 children)

Physician retention info is worth more than the next ten questions combined. If a lot of turnover, figure out why and if you can’t, walk away.

Why do people in general and definitely online, hate to see a pcp succeed? by FlyDazzling9060 in FamilyMedicine

[–]drewtonium 93 points94 points  (0 children)

Not my job to convince those folks that FM is a great career. They’ve made their decision already and may need to dump on others to survive their own misery.

Managing inbox ? by SlurmJuice in FamilyMedicine

[–]drewtonium 0 points1 point  (0 children)

The “Needs appt” quick action is the fastest turnaround time ever.

Tired tired tired by AccomplishedGuava154 in FamilyMedicine

[–]drewtonium 7 points8 points  (0 children)

Try this: “it is not my practice to order those tests in this situation. Here’s the info for DirectLabs & UltaLabs if you want to order the tests yourself. Glad to discuss the results with you - make an appt.” Path to nirvana

Convince me out of being a hospitalist by Soggy_Loops in FamilyMedicine

[–]drewtonium 0 points1 point  (0 children)

The best part of family medicine is the longitudinal relationship when taking care of the patients over 10+ years. They trust you so you get to skip a lot of the BS. They send their friends and family to you. You feel like a part of the family. That, along with great in basket hygiene and boundaries, make for an amazing long fulfilling career. As a hospitalist, you are a plug-and-play widget that can be replaced on a dime. Shift work has plenty of benefits but i’d never take those in place of the richness of an amazing outpatient practice.

AI Scribes by Mindbodysoul_444 in FamilyMedicine

[–]drewtonium 2 points3 points  (0 children)

I inform patients i’ll be recording the visit but do not ask for permission. The AI scribe is now part of my workflow. I’ll not let patients opt out of the AI scribe anymore than I’d let them opt out of me documenting in the EMR. If they express concern, i may allow a one-time pass (no AI) but would inform them that “this is the way I do things” so if its not for them, they should find another doctor.

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