I think this lab draw issue is most interesting. One caveat is that I draw all the insured patient's labs in the office, as we make some money on these, and most of the Medicare patient's labs at the hospital, as we are not reimbursed and it takes a significant amount of nursing time to draw and process. I see two scenarios:
#1
Mr. Jones comes in on Tuesday for a blood draw only. I have to have the orders in ahead of time and think about what needs to be drawn. Doing this at the previous visit may save time. If it is a Medicare patient, they may lose the order sheet, or forget to have them pre-drawn completely. On Thursday, Mr. Jones comes in and we do his annual exam and review the lab results in hand. He may have additional complaints that would prompt a second needle stick and labs, and results may require yet another follow up.
#2
Mr. Jones comes in on Tuesday for his annual exam. We review labs from last year and add any additional labs needed based on complaints or concerns. We draw blood before he leaves. On Thursday the nurse calls and tells him all the labs are normal, or perhaps we send it to the portal. (Patient being computer literate is always an open question.)Or, he has abnormalities and the doctor calls to discuss, or we set up a follow up visit to go over abnormalities and possible treatments.
Does this summarize the options well? I am looking at benefits and problems with each.
