For various reasons we have a 4 provider office that does traditional Internal Medicine as well as occupational exams for both individuals and contracted companies. The IM patients are mostly light work for the nurses (get med lists and vitals) and heavy work for the providers (interview, examine, chart, prescribe, lab management, etc.) and are done one way. The occupational patients/workers are heavy work for the nurses (PFT's, audiograms, Urinalysis, vision testing) and light on the provider (check boxes on forms).
One would think that this would be a good balance but in fact it creates a lot of stress especially with staff. IM patients all have one SOP, but the occupational ones have another SOP for sure and sometimes multiple ones for multiple companies. We used to handle the charts differently but now we have EMR for the practice and charts for the occupational - another degree of separation between how we do things.
We have kept occupational work to diversify, offer companies and workers a knowledgeable/conscientious alternative, and keep any new midlevel busy as s/he sees walk-ins and establishes her/his own patients.
Have others tried this and has it worked? How? My main identity is as an internist and with the current shortage I feel the obligation to see those patients first, but then again, it is nice to hedge our bet against the future of who-the-heck-knows-what-is-going-to-happen-to medicine. Ideas?
