Dear co-Conti colleagues:
January: the beginning of a New Year, but also the beginning of the end That is, for your seniors. This is the time we should all be thinking about transition planning for their patients.
There are several articles in the literature about this process, and combined with some of the collective wisdom of the task force, we can recommend that you at least think about the following things:
- Start early - The residents may not see certain patients again before the end of their residency, so it might be wise to get them to start saying goodbye. It is best if they can frame it positively - what experiences are they going to be moving toward as they leave the clinic ("I'm going to be specializing in Cardiology" or "I'm joining a practice" not "I've got to leave")
- Splitting up the patients - Patients with complex medical or social needs may need a more specific plan than those who are relatively straightforward. The senior and family may choose a specific current PGY1 to take on the case, instead of leaving it up to random assignment of an incoming intern; with any luck, the PGY1 will be working with the same attending as the senior, so that there is some continuity there. Perhaps a summary of the patient's main medical and social issues could be a part of the final note that the senior resident writes for the patient. On that final visit, the senior should also use the tools of the EMR to change the PCP manually.
- Making it patient-centric - Patients do want some input into the resident who will be seeing them. While we talked about a little more TLC for CYSCHN above, other families may have specific preferences about their provider or their appointment times. Honor these if possible.
- Writing a letter - It is nice to get a warning about the fact that the doctor is leaving. After Match day, you can provide the seniors with a template to alter, including positive language as to why the resident is leaving, that the clinic is still available to care for them, and perhaps even an introduction to the incoming intern that will be taking up the bulk of their practice.
- Reassigning patients - Some of the EMRs can do an automatic switch ("PCP Swap") from old provider to new. We have personally successfully accomplished this in Centricity, and in Epic.
If you have any other tips, remember that we do have a Wiki where you can start a thread about this topic
See the last newsletter for more on this topic.
And for the next newsletter, look for more details on our upcoming PAS meeting - which will be on the morning of Tuesday, May 6. Be sure to plan your plane tickets right!
All the best, and keep warm.
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Current SIG Co-Chairs:
Ada Fenick, MD
333 Cedar St
New Haven, CT 06520-8064
Phone: (203) 688-2475
John Olsson, MD
3E-132 Brody Medical Sciences Bldg.
Greenville, NC 27834
Phone: (252) 744-4422