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Re: [Gnumed-devel] gnumed handling of multiple practice MDs

From: James Busser
Subject: Re: [Gnumed-devel] gnumed handling of multiple practice MDs
Date: Fri, 6 Feb 2004 22:37:46 -0800

<x-tad-smaller>></x-tad-smaller><x-tad-smaller> Within a practice there maybe several physicians, any one of whom may be </x-tad-smaller><x-tad-smaller>
></x-tad-smaller><x-tad-smaller> the "principal" MD</x-tad-smaller><x-tad-smaller>
What do you have in mind specifically as to what assigning a principal
MD is supposed to mean ?

<x-tad-smaller>In case it was unclear (as it may have been) - I meant to refer to multiple physicians within one practice, not multiple practices.

By "principal MD" I mean Patient X ("Mary")'s preferred or designated main doctor (Dr A) to whom queries, results, issues are normally directed and with whom appointments are normally made. One cannot always assume it was the one who saw Mary last (Dr B) because Dr B may have just been filling in for A who was away or sick, or who does not work Thursdays which was the day Mary needed an urgent appointment so saw Dr B who had an open slot. It is true that if clinical or test followup were required it might be "B" who does it, but it is equally possible that "A" will be back the next day and will resume direction of care. Office staff (and docs) when fielding a call from or about any Patient X, need to know to whom to normally direct the issue.

<x-tad-smaller>></x-tad-smaller><x-tad-smaller> Where a few physicians migrate out of a practice and may be replaced by new </x-tad-smaller><x-tad-smaller>
></x-tad-smaller><x-tad-smaller> ones, or even if an ongoing member gets too busy, there may be a change in a </x-tad-smaller><x-tad-smaller>
></x-tad-smaller><x-tad-smaller> patient's principal MD. In the event the desk staff err and change a value </x-tad-smaller><x-tad-smaller>
></x-tad-smaller><x-tad-smaller> they shouldn't ought gunmed be able to display the previous value</x-tad-smaller><x-tad-smaller>
I tend to think that I do not understand the meaning of this
paragraph. What values are we talking about ? Clinical data ?
Assignment of principal MD ?
<x-tad-smaller>"Principal MD". If agreed there is value in a multi-doctor office of designating a patient's "principal" or "usual" MD, then that value may have to be change when doctors depart a practice, or when patients (or docs) request a change.
--->If the office staff meant to edit Mary Smith's record, but changed Marion Smith's, and are unsure of the prior value, can they determine it through table or audit, or must they guess or ask others? That is what I meant.

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