Medical Office Scenarios
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Part A: A pharmaceutical representative has just arrived at the office of Dr. Joseph Henderson, a board-certified orthopedic surgeon. The waiting room is swarming with patients waiting to see Dr. Henderson, because he was delayed with an unexpectedly complicated lumbar spinal fusion and laminectomy.
The representative is very insistent, almost belligerent, about seeing the physician immediately, even though she did not have an appointment to see him. In fact, the visit was totally unexpected, as the representative had just been in two weeks ago. Last time the representative was in, she gave Dr. Henderson a variety of readily usable and dispensable medications. She has more of the same today—injectable cortisone with Novocain, muscle relaxants, NSAIDs, and even some Tylenol with codeine. Usually, Dr. Henderson is quite receptive to receiving these samples, as they help ease the financial burden on his patients for whom he uses or to whom he dispenses these samples. The office is, in fact, running quite low on these particular medications because of Dr. Henderson’s heavy patient load.
Provide detailed answers for each of the following questions. Your response should be at least 150 words in length.
· What is your response to the sales representative?
· Should a sales representative ever take precedence over scheduled appointments?
· Does the fact that Dr. Henderson is usually quite anxious to receive any and all samples for his patients enter in as a factor?
· Does the diminished supply of these samples alter the situation?
· Can the medical assistant ever accept delivery of any or all of these samples?
Part B: Dr. Jonas runs a private practice. He admits patients and makes rounds in two local hospitals. He uses one type of EHR software in his private office and two other packages in the two hospitals. Not only must Dr. Jonas learn three software systems, but he also may at times be unable to move patient information between those systems because of incompatibility. What might Dr. Jonas do to address these issues? Your response should be at least 100 words in length.
Part C: Lisa Medina, a certified coder, performs medical coding for a large multi-specialty clinic. You have just been hired as Lisa’s assistant. She has asked you to review the encounter forms for the day, on which physicians have checked off the diagnoses of each patient. You notice that Dr. Parker, an endocrinologist, has checked off the box for Diabetes unspecified for most of his patients without checking off any manifestations or complications. You think this is unusual because many diabetic patients do have complications.
Provide detailed answers for each of the following questions. Your response should at least 150 words in length.
· What are the options for handling this situation?
· Which option would you select? Give three reasons for your choice.
· With whom should you consult before acting on your choice?
Part D: Sarah Egan is the office manager in Dr. Williams’s practice. Nell Jacobs, who has worked as a CMA (AAMA) in the office for one year, has frequently been absent or tardy on Mondays. Sarah suspects that Nell has a drinking problem. However, Nell has never arrived at the office intoxicated—until today. Sarah has just observed Nell stumbling in the parking lot when getting out of her car. Her speech is slurred, and her breath has a fruity odor that Sarah thinks could be alcohol. Nell does not appear to understand anything that Sarah is saying to her.
Provide detailed answers for each of the following questions. Your response should at least 250 words in length.
· Given the situation, as the office manager, what should Sarah do immediately regarding Nell?
· If Sarah decides to send Nell home, should she call Nell’s husband to come and get her, or, perhaps, insist that Nell go home in a cab?
· Does Sarah have an obligation to tell Dr. Williams about her suspicions regarding Nell?
· Should this incident become part of Nell’s employment record?
· Is this incident grounds for firing an employee?
· Because Nell is a CMA (AAMA) and works with patients, is it within Sarah’s rights to demand a blood and urine screening for alcohol and drugs?
· Should the police be notified of the incident?
· If Nell is indeed intoxicated or under the influence of alcohol, is Sarah obligated to refer Nell to counseling at an alcohol and drug rehabilitation facility?