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NH Doc would handle Specialists as well. He/she will use ones they work with.
My MIL managed to fall out with the in-house doctor because he wouldn’t prescribe her favorite sleeping tablet (understandably – it’s now on the banned list). The result was that my DH had to spend most of a day each time she needed a doctor’s appointment, as no doctors near the NH did home visits.
How easy is it to get them out to see the doctor?
How well does the current doctor care for your LO?
If your loved one needs to see a doctor every few months it might be easier to use "in house" medical staff.
If getting them out is an ordeal and sometimes unsafe then using "in house" medical staff would be safer and easier.
If the current doctor spends their time looking at the computer as they are writing notes rather than looking and talking to your loved one and you if you are present, if your loved one is a patient number and not a person then using "in house" staff would probably be just fine, as they are getting input from the AL staff as well.
Discuss with the MD service at your facility what your options are and does it mean you must change your supplemental plans would be my advice. It would be more convenient to have the MD at the facility but you need to understand all this means. For instance, in some areas it means you go to an entirely different hospital when ill.
I wish you good luck in exploring this option completely and trust you to make the best decisions for yourself. My best wishes out to you.
The reason I didn’t want to switch was that I wanted a doctor who was familiar with her medical history and provided more holistic care rather than “treat the symptom”. I also wanted a doctor who would involve me in any decision he made, whether it was an over-the-counter stool softener or a recommendation for compression socks. No more blood draws. The last time that we got a blood draw from my mother, it took over 30 minutes and a lot of bruising afterwards, because of poor circulation and they barely got a half of a vial.
Having an external PCP means I am present for all visits. It also means that I can answer any questions she has and bring up items that occurred in the past. It also means I am kept abreast of any and all treatment that my Mom has, therefore less likely to fall victim to Medicare fraud.
If I had signed over my Mom to the in-house practice, my Mom would have gone to the emergency room 5 more times in 6 months to get X-rays to ensure she didn’t have a concussion, a stool softener would have been added to her daily pill regime because they wanted BM every day regardless of how much and what she ate, she would have been checked out for UTI more times than I can remember as she started into another down cycle of dementia and she would be back on high dose prescription pain killers since she is resistant to most prescription pain killers.
I want to be totally involved in her care. Not everyone has the time or wants to be that involved.
Good luck!
By the way, no guarantee you'll see the PCP for every visit. If they have a little business within their practice, he/she could send an NP instead
They both have good portals so we can check on everything right there.
Should there come a time when it is too risky for me to take her out, I will look at changing her PCP. In that search, I will consider doctors that make house calls (very few do), as well as doctors within the in-house physician group.
When we get to the stage of palliative care, I will definitely change the PCP to an in-house doctor.
...yes, some doctors will "ghost" patients for various reasons. In fact my Mom's previous PCP took longer and longer to return calls. That is what prompted me to move her care to this geriatric doctor, whom so far, has worked well.
Mom has a wonderful primary from a Visiting Physicians group that comes to her. Unfortunately there are no after hours care except the ER. Mom does have mobile lab and Imaging services. She is also enrolled in palliative care due to her dementia. Our goal is to avoid the ER and a hispitalization if possible.
If she moves to ALF I would definitely use the in house physician because of convenience and timeliness of care.
Fortunately for us mom's primary also is part of the ALF team.
As aging increases so does the health issues they are dealing with now. There will be more needs for doctor visits
check billing.
my mil was in mc and dying. Facility called me at work and i came over. I was a nurse aide working evenings.
after she died the nurses told me that they had called the doc but he wouldnt come. BUT he still sent us a bill for a visit.
i wrote him a nasty letter and said we’d better never receive another bill from him etc. if he was asked to come up didn't show up.
i can understand him not going but dont bill us for a visit !
he never contacted us again.
so i would ask about the doc’s role … is that the only facility they service or are there more or are there more facilities AND a regular practice or ??? Is a bill received … or sent to medicare/medicaid … automatically just since they service the facility even tho you see an outside doc ?
My DH is in MC now and their in-house practice is wonderful. He's seen monthly by a NP specializing in gerontology. More often, if needed. The portal is a great way to keep in touch and also alert them to any concerns I have as a family member.
Like everything else, there's no one correct answer, but some pros and cons to consider. I would maybe make sure you could change your mind if the in-house providers don't work out for some reason. Good luck with your decision.
My DH is in MC now and their in-house practice is wonderful. He's seen monthly by a NP specializing in gerontology. More often, if needed. She's personable, smart, and thorough. The portal is a great way to keep in touch and also alert them to any concerns I have as a family member. I know when she's coming and if I'm not there, she always calls me to let me know how it went.
Like everything else, there's no one correct answer, but some pros and cons to consider. I would maybe make sure you could change your mind if the in-house providers don't work out for some reason. Good luck with your decision.
And by the way...every single medical chart I reviewed had atrocious medical errors, wrong drugs, and misinformation in them, including weight and diagnosis. When I asked the families to meet with me so we could discuss care and I showed them the medical chart, they were as shocked as I was!
This same PCP "passed" her off to an out of state doctor who was there to get experience; this doctor eventually returned to her state to start her own practice.
Point: if a procedure is recommended check out the recovery time, the effort involved by the patient and risks vs benefits. I didn’t hesitate to say “no.” Mom died peacefully at 99.
Good Luck
I have Bipolar Disorder. I can tell when my meds need to either be adjusted or changed altogether. A few months ago I told the "Dr." -and I use the term VERY loosely-that I needed to change either the dose or the med altogether. Long story short, he didn't do ANYTHING until AFTER I did irreversible harm to my relationship with both my oldest sister who'd been there through thick and thin and an old friend who I had for 50 years. BOTH of whom want nothing to do with me-I don't blame them.
Stick with what or in this case WHO works!
Good Luck.