Practice Management

  • 1.  Collaborating with Advanced Practice Providers

    Posted 12-06-2020 16:26
    I was wondering how practices with MFM MDs and Advanced Practice Providers (APPs) review or sign off charts given APPs are independent providers, but seeing complex patients for consults or care coordination. At UNC we are currently using the language of an MD was immediately available if the plan of care was not reviewed in real time prior to documentation review versus "the plan of care was reviewed with Dr. ___ ". Some of my APP colleagues do not believe all new or consults should be reviewed by an MFM unless there are questions regarding the plan of care. What do other collaborative systems do?

    Erin Huprich, NP
    UNC Chapel Hill

    Erin Huprich

  • 2.  RE: Collaborating with Advanced Practice Providers

    Posted 12-06-2020 18:03
    We have been working with NPs for close to a decade.  As with all circumstances there are differences based upon personnel.  Most of our outpatient care is for GDM by our NPs.  They are better with these patients now than our physicians to be honest, they spend more time with the patients and educate better.  Nonetheless, many of our GDM patients also have concurrent problems which create greater difficulty.

    For the former, our doctors are sent every note for review but are not co-signed.  For the latter, our docs will ask for collaboration with us and discussion of the case and this is placed within the notes.

    Brian Iriye

  • 3.  RE: Collaborating with Advanced Practice Providers

    Posted 12-07-2020 18:04
    We have been working with NP's in our office for over 25 years. One of our NP's is a certified diabetic educator. We use macros and clinical standards for new patients with common diagnosis. While the NP usually runs a new patient by the providers, things such as diabetes and CHTN may not be checked out due to the comfort of our NP's with these diagnoses
    Our providers see all US diagnoses however our NP's are NTQR certified and often pre-counsel our abnormal first trimester US for CVS prior to being seen by the provider which is also very helpful
    We use NP's in the hospital as well. We do co-sign all of her notes due to hospital regulations at our facility.

    Cornelia Graves