Multispecialty group medical practice

/0 Comments/in /by

Dr. Moe, Dr. Howard and Dr. Fine are principals in a multispecialty group medical practice. Dr. Moe is a primary care physician. Dr. Howard is an internist, and Dr. Fine is a radiologist. They jointly own an office building which also houses a clinical laboratory and state-of-the-art radiology equipment.

Dr. Howard supervises the lab, and makes the most use of its facilities, ordering the majority of lab tests for patients. Dr. Fine uses the radiology equipment almost exclusively. Dr. Moe treats the greatest number of patients, and makes the most referrals to the other two physicians.

All billings to Medicare and other payers for the group practice are made under a group billing number. Income for the practice, though still quite substantial, has declined in recent years.

Dr. Moe is concerned that the costs of the lab and radiology equipment should be charged to each doctor according to utilization, and that he should receive credit for the patient business he refers to the other two doctors, when they divide the group profits at year end. Dr. Howard believes he should likewise receive credit for the revenues he brings in from his use and supervision of the lab, and Dr. Fine believes he should receive credit for the revenues he brings in from his extensive use of the diagnostic radiology equipment.

The three doctors have considered billing separately for the services they each provide to their patients. They do not want to dissolve the group, and have engaged your services with regard to developing a compensation arrangement that will reward their individual productivity while remaining in compliance with the Physician Self-Referral prohibitions.

  1. How would you advise each of the three doctors?
  2. What are the intra-group referral implications for Medicare billings and physician compensation?

 

Focused respiratory assessment

/0 Comments/in /by

When completing a focused respiratory assessment, what intervention should the practical nurse (PN)
implement to assess for hemoptysis? A Determine how often the cough occure. OB Observe the appearance
of sputum Oc watch chest expansion on inspiration OD Auscultate bilateral breath sounds.

Phishing and spam emails. 

/0 Comments/in /by

You are providing education to the hospital staff on phishing and spam emails.

 

Using the following education methods:

Instructor led

eLearning

Self-guided

Just-in-time

blended learning

 

Provide examples of how each education method can be used in teaching about phishing and spam emails and explain how the learning method can best be evaluated.

Hydrocele

/0 Comments/in /by

What relevant National guidelines related to diagnosis and diagnostic testing for Hydrocele, Inguinal hernia ad Orchitis?

Please Provide References in APA format

Career

/0 Comments/in /by

You have been assigned a “career” by your instructor.  Please respond as if you are healthcare team member with your assigned role.  You may have to conduct further research on the career if you are not familiar with the role.  Your peers will be tackling the same assignment, from a different role perspective. Review the case of Emma Taffery and respond to the following questions with your assigned role.

 

Your role: Respiratory Therapist 

 

1. What your focus is in that role

 

2. What resources Emma might need

 

3. How you can work with other team members (e.g. RN, pharmacist, physician, social worker, physical therapist, occupational therapist) to provide the best care and outcomes for Emma

Severe exacerbation of asthma

/0 Comments/in /by

Ms. Robinson is admitted to the hospital with a severe exacerbation of asthma. She has inspiratory and expiratory wheezing throughout her lung fields. She is dysgenic at rest. She has a frequent moist sounding cough. She has intercostal retractions. Her pulse ox is 87% on RA at rest. What interventions would you expect would benefit this patient . State whether or not you would require physician’s order for the intervention.

Scrotal pain

/0 Comments/in /by

What associated risk factors and demographics that contribute to scrotal pain, Scrotal mass or scrotal pain?

Please provide reference within 6 years  in APA format

REBT (Rational Emotive Behavior Therapy)

/0 Comments/in /by

Teaching REBT. REBT (Rational Emotive Behavior Therapy) is an effective counseling theory to use in groups. Now that members have stated where they think their guilt is coming from, write down how you could teach the concept of REBT to the members in an engaging manner.

 

what members had to say :

 

>> So you all have done some really good work in group and, you know, we’ve been talking about this issue of guilt, you know, and the work that you’re doing around guilt. And I wanted to sort of go over something here this evening that I thought might be helpful. And so in getting started with this I want you to think about where does your guilt come from. For example, if I was going to give you a test and the one test question was where does my guilt come from, how would you answer that test question?

>> My past.

>> Your past okay, I’m going to list these up here. So your past okay.

>> And things I’ve either done or haven’t done.

>> Okay.

>> Yeah.

>> What about others of you? Jen’s saying her past, what about others?

>> My religion and my mom.

>> Oh okay, so mom. Sone others of you have talked about guilt related to mom too.

>> And my religion yeah.

>> And religion okay.

>> Yeah.

>> Mine’s kind of not being a good mom.

>> Not being a good mom.

>> I feel — yeah.

>> Okay.

>> Not being a good mom.

>> Anybody else, yeah Eric?

>> That accident I had with a kid that ended up in the wheelchair.

>> Oh okay, so the car wreck?

>> Yeah. Okay, Morgan we haven’t heard from you, how about you? Where would you say your guilt comes from?

>> Being an unsupportive friend I have a lot of guilt about that.

>> Being an unsupportive friend?

>> Yeah.

>> Okay. Okay, right so you all have all of these things that go on in your life, events or situations with your mom or being a mom more or Jane, how about for you?

>> Mine is like marrying American and my parents are just afraid I’ll lose my heritage and not going back to Taiwan anymore.

>> Okay, so marrying the wrong person?

>> Yeah.

>> According to your parents?

>> Yeah.

>> Okay. Yeah, so events — you see how these are events or situations or things that go on in our life, marrying the wrong person, you know the car wreck.

Bipolar disorder and anxiety

/0 Comments/in /by

Patient is a 47-year-old woman with bipolar disorder and anxiety. She has been stable on a combination of duloxetine and quetiapine for a number of years. She smokes, and has diabetes, hypertension, and hyperlipidemia. She is concerned about her weight and asks whether there are medications that she can take to aid in weight loss. She says that she has been told indirectly, by her friends and family, that she is “overweight.” She has tried several “fad” diets without lasting success. She has not been unable to maintain any weight loss for more than a few months.
-She tells you that she “watches what she eats” and reads the nutritional labels on food packaging but enjoys eating out and often orders take-out meals. She works full time and spends most of her day sitting in an office. She belongs to a fitness club, but her attendance is inconsistent.
-She also confides that she has trouble reaching orgasm regardless of what she tries.   Questions:

-What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence.
-What would be our approach for the sexual side effects she is experiencing?
-If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?

Christian worldview

/0 Comments/in /by

Christian worldview pertains to the way Christians see the world, their relationship to God, and how they interpret interactions with their environment. In what way did you incorporate your Christian worldview into your work with the DPI Project on promoting breastfeeding? Support your position with evidence or scripture.