They know how to ask about cardiovascular symptoms and easy bleeding and bruising, and prior complications from anesthesia or surgeries. The surgeon's office staff should be able to ask what the patient's past medical and surgical history are, what their allergies are, what medications they take. On the other hand, when we get a pre-operative form shoved at us, requesting that we copy information from our chart onto their form, it feels like we are doing menial tasks that don't add to the care of our patients. I love it when a surgeon asks me, "Are these patient's medical conditions optimized? What do we need to change before surgery? Any medications we need to start or stop or adjust, or any tests we need to do? Or do you think it is just not in the patient's best interest to proceed with this surgery at this time?" We often know our patients best, and when they ask us the right questions, we really appreciate being involved in the care of our patients as they head for surgery. There is often in our pre-operative evaluation a great deal we can do to help the surgeons. What they really wanted was someone to check the box. The surgeon's office had responded that the state where they were performing the surgery required a history and physical be documented on the patient within 30 days of surgery, but all of that information was contained in the previous note that we sent to them, and someone from their office was probably perfectly capable of filling that information out on the form, copying it from our previous notes. My colleague had performed the requested testing, including a large battery of labs, an EKG, and a chest x-ray, most of which were felt by them to be unnecessary, but had been insisted on by the surgeon's office.Īs requested, all of these medical records from our practice, the notes with their recommendations along with the results from the requested testing, had been faxed to the surgeon's office, and in the interim the patient had undergone the diagnostic procedure without any apparent complications.Ī few weeks after all of this, my colleague had received another fax from the surgeon's office, now for this planned, more invasive surgical procedure, with a request that they simply fill out the pre-operative form and fax it back, without seeing the patient, "clearing them" for the surgery. My colleague told me that they'd seen the patient before the initial procedure, reviewed their past medical history, assessed their surgical risk, and made some recommendations about the patient's medical conditions to help the surgeon through the peri-procedural period for this fairly low-risk diagnostic procedure.
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