I would echo almost exactly the well thought out response of SoCalFP. I have found it much more efficient to order the labs in advance of a routinely scheduled follow up visit, so that the patient and I may go over the labs at the visit, have a real time discussion about them, and make any adjustments to the plan before the patient leaves. This is much easier than trying to track down the patient after the visit, and much more convenient than having the patient come in for a follow up visit to go over the labs.
Like SoCalFP, I think about the interval for the next follow up visit before the patient leaves my office. I think about what tests need to be ordered and give them a lab order sheet. I tell them to get the blood work a few days prior to their visit with me. Our lab keeps the blood work in the freezer for 6 days before discarding, so if a test needs to be added, it can usually be added on to the blood work that has already been done, rather than collecting a new sample.
That being said, it is sometimes the case that we have to send the patient for new blood work if a new issue presents itself at the visit.
If it is a new patient, or a visit for an acute problem, we usually do not get the blood work in advance of the visit.
Most of my patients like this system. Since they have been doing it for a while, I think going back to the days of getting the blood work at the time of the visit would seem strange to them.
With regard to prescription refills, this is still a problem at our practice. I do not try to coordinate the refills with the visit. I tried to do this, but I think this is almost impossible for a whole variety of reasons. My philosophy is not to charge a fee to refill the Rx, though other practices do. For me, as long as the patient is current with their visits, I will do the refill. My preference is for the patient to call the pharmacy directly for refill requests. This part of it solves the issue of the patient calling our office when they still have active refills on the prescription. If there are truly no refills, then the pharmacy sends an electronic (usually) or faxed (less frequently) request to us. These are somewhat cumbersome, but still much easier than the old days as they come in the refill request que of AC and can be dispensed with in a few minutes.
I am curious to hear what others do.
