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The medical assistant is responsible for a variety of office duties. The assistant has a duty to the doctor and patients at the clinic. The assistant should let the representative know that the doctor had a lengthy procedure and is running behind on seeing patients in the office. Furthermore, she should calm the representative down and explain that she will talk with the doctor and see if he is going to be able to fit her in to discuss receiving sample medications. If the doctor is able to see the pharmaceutical representative, then the medical assistant can discuss an appropriate time for her to meet with the doctor. Therefore, the individual should check with the physician prior to arranging a meeting.
Sales Representative Precedence
It is well known that pharmacy representatives travel around from clinic to clinic to provide physicians with medication samples. These individuals are paid by big pharmaceutical companies to market specific drugs. Doctors are often provided samples of these medications and awarded incentives to prescribe these medications to their patients. Normally doctors will see representatives between patients or they may schedule an appointment to speak with the doctor about these medications. The priority of the clinic and the medical staff is always to provide the most efficient care to the patients as a top priority. The representative should not take precedence over schedule patients because most of them come to the clinic because they are sick or need to receive refills on their medications. Therefore, patients should always remain the top priority.
Physician Urgency
Since Dr. Henderson is running quite low on all of his samples this may be considered a factor. The doctor uses these medications to help take care of his patients that cannot afford to pay a great deal of money for their medications. Since Dr. Henderson is running low he may be concerned that if he doesn’t meet with the representative then he may have to wait for another scheduled time which could be detrimental to his patient population. Therefore, Dr. Henderson may decide that he needs to fit the representative in between seeing patients.
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Diminished Supply
The doctor uses the mediation samples to supply his patients who are low income or cannot afford to pay for expensive medications. Since the doctor is running low on supplies does alter the situation because he cannot afford to run out of medication to continue to help patients. If the doctor thinks that he may not be able to get supplies if he doesn’t see the sales representative, then he will definitely want to make time to speak with the representative to make sure that he is able to obtain the medications that he needs today without having to wait for the individual to come back at a later date. Therefore, the diminished supply will definitely play an important role in making time for the rep.
Medical Assistant Role in Samples
There are set guidelines for medical assistants in relationship to being able to receive medication samples. A medical assistant may or may not be able to accept samples depending on the state where they practice. According to research information, the medical assistant can administer medications under the supervision of the physician (Buppert, 2008). Therefore, the individual should follow specific guidelines depending on the area where they practice as an assistant.
EHR Software
According to the information provided Dr. Jonas uses three different types of EHR software systems. The one that he uses at his private practice and the two different types that he uses in two different hospitals. The best thing for Dr. Jonas to do is to find a company that is compatible with the packages from the hospital and then he would be able to admit or transfer patient information between the systems. Dr. Jonas would need a way to become interlinked with the computer systems at the two hospitals that he practices at and then would be able to view, admit, or transfer patient information. Therefore, he would need to be linked with the software from the hospitals.
Options
There are several options for handling the situation noted where the doctor did not check any complication or manifestations in relation to diabetes. The first option would be to check for any coding policies or procedures that would help identify if there should be any complications noted. The next option could be to ask Lisa the certified coder any of these boxes that list manifestation or complications should be checked. The last option could be to address the issue with Dr. Parker to see if this was an error or whether it did not need to be checked off.
Option Selected
The best option would be to go to the source to find out if this was an error or if it did not need to be selected. The source that I would choose would be Dr. Parker since he checked the diabetes unspecified box but did not check off any clinical manifestations or complications. The primary reason for making this choice is that he is the one that is seeing the patients and would know if they had any other complications. Secondly, he would be a better source than using the coder or the coding policies or procedures. Thirdly, it would require less time than trying to use other methods. Therefore, this would be the best option to find out more information.
Consultation
Before acting or speaking with Dr. Parker in person the best person to consult would be Lisa the certified coder because she is your boss since she hired you as her assistant. Lisa would be in a better position and would know more about the coding rules in relation to the encounter forms. She may know whether this is a normal procedure or if it warrants further investigation. Therefore, she would need to be consulted prior to going directly to Dr. Parker.
Immediately
The office manager, Sarah should immediately take Nell into her private office to discuss the situation. Sarah should question why Nell was stumbling in the parking lot and why she has been absent or tardy on Monday’s.
Next Step
The best option if Sarah decides to send Nell home would be to contact her husband to come and get her. The reason this would be the best option is that he could make sure that she gets home safe. If Sarah calls a cab to take Nell home, she may change her mind or go somewhere else instead of going home. Therefore, Sarah would protect herself by making sure that she gets home safely.
Obligation
Sarah has an obligation to tell Dr. Williams about her suspicions regarding Nell because the doctor is her employer and since she is the office manager the doctor has a right to know what is going on in his office.
Employment
If Nell has truly been drinking and showed up to work intoxicated, it should be put in her employment record of what action was taken in relation to her intoxication. Furthermore, the documentation should also include a statement from Nell, type of offense, individuals notified, and any recommendations.
Grounds
According to most rules and regulations, employers will not tolerate an employee being under the influence of alcohol or drugs. Violating this policy is considered a serious offense and will result in termination of the employee. Therefore, if Nell was truly intoxicated her position should be terminated.
Screening
Since Nell is a CMA and works with patients Sarah has the right to obtain a blood and urine screening for alcohol and drugs since she showed up at work and appears to be intoxicated and could also be under the influence of drugs since she does not appear to comprehend anything that Sarah is saying to her. Most employees when they are hired sign an employment agreement that they may be screened at the discretion of management if they are suspected to be under the influence of drugs or alcohol. Therefore, Sarah is within her rights to ask for a drug and alcohol screening.
Police
As long as Nell does not appear to be a threat to any patients or to the office personnel the police do not need to be contacted at this point. Therefore, the police do not need to be notified at this time.
Counseling
If Nell is truly under the influence of alcohol Sarah can offer to refer her to counseling to a drug or alcohol facility. However, Nell may refuse to seek such treatment and Sarah can only offer the service to her. Sarah cannot force Nell to go to counseling and is not under any legal obligation to refer her. Therefore, she may suggest counseling, but it not required to do so.
References
- Buppert, Carolyn. (2008). Understanding medical assistant practice liability issues. Retrieved
- from https://www.medscape.com/viewarticle/580647_2
