Hi everyone,

This is a response to David's original question, which started this thread.

I am approximately 50/50, concerning labs in advance or ordered at the visit. Will I echo David's sentiments, my ability to predict the labs needed at the time of the next visit is sometimes good, sometimes not.

How ever, I also have a very practical concern with ordering labs four or six months in advance. Very often, the patient will lose the order, and call a week before the visit requesting a new order. I find reprinting an order very cumbersome and time-consuming. Perhaps if AC had a two click process to reprint the orders, I would do this more frequently. If I'm missing something, please let me know, but I pull up the last note, and reselect the tests, one by one, then reprint the order.

If labs are ordered at the visit, I typically send patient a brief letter with results and recommendations. I may be the only AC user left not using Updox. My patient population is much older, and I think the percentage willing to go online for results would be rather small. So we actually mail a paper letter to them. The letters typically will be three types.

First, is a simple "Everything was excellent", and I typically will list values for sugar, total cholesterol, HDL and LDL.

The second is a letter with simple instructions. "Your thyroid was low, please increase your thyroid medication from 88 ?g to 100 ?g, and have repeat blood work in two months. I enclose a prescription for your new dosage, as well as for bloodwork in two months."

Finally, for a complicated issue, "Your A1C is very high at 9.5. Please schedule an appointment at your earliest convenience so we can discuss this further."

Gene

Gene Nallin MD solo family practice with one PA Cumberland, Md