DOC Newsletter: February 2012

1. Set 1-2, Hut, Hut, Hike Rumor has it, Schulteis taught his kids snap counts before they could roll over. No wonder he’s so efficient in clinic. For that matter, even Eli Manning huddles before the big play, and so should you. Clinic runs most efficiently when you work closely with your assigned nurse. A huddle at the start of clinic can mean the difference between a day of dropped passes and a day of touchdowns. Check the white board to find out who’s your star receiver for the day (i.e. think of Johna as your Jerry Rice). Playing ‘House’ Since June 2011, select SARs have taken part in a new DOC venture—the Diagnostic Clinic. Patients from afar with diagnostic conundrums find their way to our hallowed halls for a one-time, ultra-intense, blood sweat and tears, hour-long new patient encounter. Nothing goes unturned. Not even the rectal exam. These visits have been clustered as 3 visits per clinic session based on SAR feedback. We’ve been doing around 3 clinic sessions per month. How ‘bout them apples? (They don’t keep the doctor away, apparently.) It won’t be long… Unitl Brandie and Makayla are headed to L and D! Be sure to wish them well the next time you see them. Dan Fox will be holding diaper changing classes during preclinic conference on the 3rd Thursday of every month in their honor. DOC Newsletter: February 2012 Referrals Galore! Banging head against wall, eval and treat: We make a lot of PT referrals for back and knee complaints, but changes are on the horizon. Medicaid coverage for PT, OT, and speech therapy is now limited to 1 therapy evaluation and 3 visits per year except for patients with CVA, TBI, SCI, joint replacement, and amputation (who will have higher, but similarly unappealable limits). Scooter evaluations count as that 1 therapy evaluations, much to the chagrin of The Scooter Store. Please pass the sugar: along to the every other Friday AM diabetic teaching sessions. Just circle the referral on the encounter form and watch those A1Cs drop like they’re hot. In some cases, we’ll settle for lukewarm. Ongoing Studies Depressed patients staying that way? Refer them to a study examining conventional vs. spiritually-integrated psychotherapy for depression.  All patients receive treatment (there is no control group).  After telling the patient about the referral, contact Dr. Koenig atkoenig@geri.duke.eduor call 681-6633 and leave a message with the patient's name and contact information. Pink puffer patient panel? Keep an eye on the white board by Dr. Bowlby’s office for any upcoming studies—asthma and COPD enrollment will be just around the corner. • Admin Time: What to Expect • You should not expect to: check in and then check out, balance the books for the clinic, play with the liquid nitrogen, fax pictures of your gluteus to Jon Bae for his collection, practice joint injections on yourself • You should expect to: check in with the nurses, catch up on paperwork, help out with medication refills, offer up your general pleasant demeanor to serve in as helpful a capacity as possible . PP Folders May be getting a little TLC over the next several weeks. Feel free to send along any suggestions for modification to your friendly neighborhood Ambulatory ACR. All ideas will be considered. Especially crazy ones. (Read: innovative) Reminders With the wild success of the patient early arrival intervention, patients are ready to go at 8:30am, so skip the Starbucks and get yourself to clinic on time! Dictaphone death is a thing of the past. Thank you Randy Heffelfinger for solving our rechargeable battery woes. And making sure that lame excuse never crops up to explain away those 2-week-late dictations. Tasking is alive and well. Be sure to check yours 2-3x per week so you stay that way too, buster. Schedule questions? Turn to the veritable residency crystal ball—MedHub has the answers. MedHub is THE authority for the most up-to-date schedule anywhere. Period. The DRH/Ambulatory ACR is also always happy to help with schedule demystification . Greenblatt’sCorner QI, Innovation, Mental Health, Oh my! We are looking for 4 partnerships to introduce an evidence-based strategy to both screen for and manage patients with major depression. We will have support from Sarah Rivelli and Marvin Swartz in Psychiatry. This will be the first depression management algorithm to be implemented in a resident clinic. We need 4 partnerships with SAR's who are willing to serve as leaders for their individual partnerships. Contact Dr. Greenblatt to learn more. You, too, can prescribe judiciously: From this point forward, you will receive a copy of the wildly popular Rx Bytes free of charge with your DOC newsletter. The ePub includes high-yield medication information tailored to providers who see a large volume of Medicaid patients. Last month’s edition includes helpful tidbits about acetaminophen, a list of which healthplans cover what drugs, and a means of accessing Rx fill data for Medicaid patients. Just wish it had a photo of Dr. Greenblatt’s catching smile! Maestro Care: Enjoy the Symphony Buff those patent leather shoes and tighten your bowties for July 18th! Duke Intranet ‘What’s new’ has a great Maestro Care link to help you make sure you don’t miss a beat—practice will keep your practice on key.And if you have prior Epic experience, Dr Bowlby may have front row seats for you, so please contact her!