5 posts • Page 1 of 1
Ken- do you think you will do inductions without a documented physical?? I am thinking of doing the problem focused exam- we do have a table- my concern is I do not want to get involved with dressing/undressing or gowns- the exam as described in the guidleines is not unreasonable- and again I think I could do a better job than a doc in a box providing a "physical" for reimbursement- I don't have guidelines accessible but I will cut and paste them when I do- I do believe they include listening to the heart and lungs and****essing liver size and stiffness. I am pretty confident I can do that adequately without having pt underess. I don't think this is thoughtless - I think in fact they are made by real world docs from asam not nonclinical peeps. it is just going to be a hoop that my patients will have trouble jumping through- I ususalyy get them hooked up with a pcp for a physical but not when they first present because getting them stable has been my priority....
I'm not a Psychiatrist, I am Family Practice and the definition of "Complete Physical" is very subjective depending on which authority you ask. I doubt a pelvic exam or digital rectal exam should be necessary to initiate buprenorphine treatment. I think the guidelines are another example of non-clinical people making guidelines for those of us in the real world. It would be nice if every patient could get a complete physical, but that is not always practical in the real world of addiction treatment. Sometimes we just have to use our clinical judgement (Gasp!).
Who is online
Users browsing this forum: Google [Bot] and 2 guests