Is this Patient-Centered?

My physician's group utilizes an on-line patient portal to schedule appointments, view lab results, and to communicate with my provider. Fortunately, it is very rare that I need to actually schedule an appointment. I've only been a patient of the practice for just about 2 years and I thought I'd schedule my second annual physical. (In fact, I've been there once, a year ago, for a physical on a Saturday). Now, I do question the real value of the annual physical examination but as we all get a year older, there are certain screenings that are recommended.

Nonetheless, I fired up the handy patient portal web address and requested a physical examination for any early Saturday appointment in June or July. Since I do work Monday through Friday with my own patient load and responsibilities, I don't think I should need to take a day off to have a physical. The practice has Saturday hours and I thought this would be ideal for me and my schedule. This is the response that I got back from the office staff:

Dear Mr. Ferrara: We don't have our schedule in for June yet. Our schedule for Saturdays will go in at the end of May. I'm not sure which Saturday Dr. X will be working. We don't usually do physicals on Saturdays because it's a short day he likes to keep it open for emergency sick visits so if you could come during the week Dr. X is late on Monday nights. Thank you.

So what is one to do? I am extremely annoyed at this response. Mind you, I have absolutely no current medical issues, am not on any medications, have health insurance, and in all likelihood, I would be in the waiting room longer than I would actually be in with the clinician. They can even code higher for a physical than for a sick visit! I am not asking for any favors or special treatment, just to have a Saturday appointment - up to 8 weeks from now. Is that too much to ask? Apparently so.

And some wonder how to fix the many problems of the health care system today. How about we start with access and getting our foot in the door.

Private Practice

There is an interesting trend that I'm observing and don't necessarily see how this is going to turn out. I'm seeing more and more nurse practitioner's opening their own autonomous practices. Many of these offices set out to offer care that is personalized, covered under insurance, and of course high-quality. I'm also seeing more NP specialty/sub-specialty practices such as house calls, incontinence, and women's health. This is in a time when more physician practices are joining together in these conglomerations that aren't necessarily tied to hospitals. You'd be hard pressed to find a solo primary care physician these days yet nurse practitioner solo practices are popping up. The talk about the formation of accountable care organizations can be attributed to health care reform and the spurring of large multi-physician practices. What to make of this? I honestly don't know. Many people and patients have said to me "you should start your own prac

NP Residency

The healthcare system of today is so complex yet so dysfunctional that I believe the time has come to educate and train the NP providers of tomorrow in a way that is reflective of that complexity. We have done a good job up to this point but need to bring that to the next level. Residency. I'm not necessarily referring to the typical residency training of physicians which takes place in hospitals but a residency-type of program in an out-patient setting (ironic that we use the term residency). We realize that healthcare is not exclusively delivered in hospitals. It takes place in independent providers offices, in community health centers, in mobile health vans, and in retail settings. It takes place in people's homes and places of employment. It takes place in many of the health decisions that we make on a daily basis. I found this NP residency program in Connecticut that claims to be the first NP residency in the US. The programs admits 4 NPs each year and trains them to ha

Guest Post: The Pros and Cons of Legal Nurse Consulting

The Pros and Cons of Legal Nurse Consulting I’ve spent years pursuing different avenues in the health care industry. I spent my high school years studying to become a CAN, I was at one point a EMT, and I eventually turned to alternative practices like massage therapy, herbs and general fitness and nutrition. Not long ago, though, I heard a term that was relatively new to me – legal nurse consulting. My aunt told me about her pursuit of a legal nurse consulting certification. Her goal was to pass the certification exam and open her own business, partnering with lawyers around the country to help them understand medical charts and the medical profession as a whole. Sounds great, right? I’m wondering if it really is. I urge anyone who is considering legal nurse consulting to consider the pros and cons. While it is certainly an admiral and profitable career path, it may limit your future choices. First of all, legal nurse consulting is not a get-rich-quick solution to your problems. If you

A Nurse Practitioner's View

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