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Joel,
 
It would be inappropriate/illegal for anyone other than the ordering
physician to change the order.  I would suggest taking lunch to the PCP's
office and do a lunch and learn session and educate them on the basics of
vascular test ordering.  It is a small investment into establishing a strong
relationship with the PCP's that will pay off later. In my practice we give
them a 1 page brochure that matches the test to an approved indication.  We
also let them know that rule out's and family history are not appropriate
indications.  
 
Contact me off of flo-net and I can send you the brochure we use.
 
Phil White BS RVT
 
  _____  

From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Joel D
Sent: Thursday, February 17, 2011 7:48 AM
To: [log in to unmask]
Subject: Vascular Lab Test Ordering Logistics
 
We are a newer outpatient echo and vascular lab 9cardiac and vascular
office).  Up until this point we have not gotten a lot of outside referrals
from physicians we may not be familiar with.  Most of our tests are ordered
internally so if there is a problem with the type of test that is ordered,
we take up with that physician tell them why the test they ordered is
inappropriate, switch it and move on. 
 
Now that we are getting more outside referrals from primary care etc., the
question is... What is the best way to make sure the patient gets the
appropriate test?  I'm thinking  definitely review the test ordered a day
ahead of time.  But then do we just switch it to what our dr. thinks is
right or should we page the ordering physician (PCP) in the middle of their
day every single time?  We obviously like the referrals and do not want to
make any one upset by switching their test, but some of these are just
blatantly the incorrect test.  I had one of our techs page the referring
yesterday and he was on vacation so she did what was indicated, seeing that
what was ordered did not have proper indications.  I know all of you have
had these experiences  and I also know I will never eliminate this situation
entirely but in your experience what is the best practice to engage in from
a day to day standpoint to avoid these as much as possible?  Much
appreciated.
 
Joel Dykstra RVT, RDCS
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