What is the Accurate Clinic’s “Coordinated Care Program?
When medically appropriate and with our patient’s consent, we coordinate the medical care of our patients with the our patient’s other managing clinicians, such as their primary care physician, cardiologist or psychiatrist. We will fax information at appropriate time intervals to these other clinician’s to keep them appraised of how our patients are doing. This may include such aspects as how well their chronic pain, anxiety, depression or blood pressure is controlled. It may also include sharing important test results such as blood tests or genetic tests. Also, we may contact another clinician to facilitate an earlier appointment for our patient: for example, if we determine our patient has poorly controlled blood pressure and needs a timely assessment or change in treatment.
Why is coordinating care important?
One of the leading causes of morbidity and mortality (poor health outcomes and death) in this country comes as a result of a lack of communication between multiple physicians managing the same patient. The most common problem is unexpected prescription drug or supplement interactions that occur when two or more medications or supplements are prescribed to a patient by separate physicians, ofen filled at separate pharmacies, which result in unanticipated drug interactions causing harm or death to a patient. Unfortunately, this occurs far too often in this country. This is the primary reason we engaged our coordinated care program prior to 2010, particularly with respect to the prescribing of pain medications.
It is also important for clinicians managing certain conditions to communicate with one another. For example, in the management of chronic pain when a person’s anxiety or depression are poorly controlled it is much less likely that the patient’s chronic pain will be well controlled, or vice versa. In this circumstance communication by separately prescribing physicians may result in a better outcome for the patient. Also, in many such cases the medications used to treat pain may be the same or similar to those used in treating anxiety or depression. If the physicians managing these conditions communicate effectively, the outcome may be better choices in medications and greater benefit or less side effects for the patient.
Hospital Emergency Room and In-patient Advocacy
Emergency Room Care
Going to an emergency room for medical attention is rarely a comfortable event. In the very least, anxiety is high regarding the emergency condition and the potential for a bad outcome. Concerns are also likely to be present whether the emergency care will be appropriate and meet the individual needs of the patient, whether all that should be done will be done, and whether the emergency room staff will know what they need to know about the individual patient to provide the most appropriate and effective care. Or maybe there is uncertainty in the first place as to whether it is necessary to go to an emergency room at all.
At Accurate Clinic our patients are encouraged to contact Dr. Ehlenberger when desired and appropriate prior to going to the emergency room for care. Communication with Dr. Ehlenberger may confirm the need to proceed to the emergency room and, if so, Dr. Ehlenberger may be able to contact emergency room staff to inform them prior to patient arrival of the pertinent information needed to facilitate timely and effective care. Dr. Ehlenberger can play the role of patient advocate to help insure that the emergency room experience is as optimal as possible by communicating with the patient, their family and emergency room staff. It is often very helpful to have another emergency specialist physician as a patient advocate overseeing the emergency care of the patient.
It is unfortunately far too common for chronic pain patients, for example, to sometimes be treated hastily and unsympathetically by emergency room staff who sometimes treat the pain patient rudely like a drug addict seeking drugs. For that matter, addiction patients are also often treated inappropriately in emergency settings. These experiences by Accurate Clinic patients will not be tolerated and if it occurs Dr. Ehlenberger with intercede as necessary to correct the situation.
Dr. Ehlenberger is board certified in Emergency Medicine by the American Board of Emergency Medicine with more than thiry years experience working in emergency rooms including more than twenty years experience working in academic emergency rooms in the New Orleans area (including Tulane and Ochsner). He is qualified and interested in making certain his patients are treated appropriately in emergency settings.
In-patient Hospital Care
As a hospital in-patient recovering from surgery or other illness, patients are entitled to adequate control of their pain. If this is not provided, it is both unethical and grounds for malpractice as it violates the Patient Bill of Rights entitling all patients to safe and effective pain control. Dr. Ehlenberger encourages his patients or their families to contact him under such circumstances and he will intercede as appropriate on his patient’s behalf. It is generally our practice at Accurate Clinic to communicate with our patient’s surgeons prior to surgery to plan for appropriate post-operative pain management.
What else does Accurate Clinic do to improve coordinated care?
As part of our opiate chronic pain program we provide “wallet cards” to our patients to facilitate coordination of care to our patient’s other prescribing clinicians. The wallet card provides patient information including the date of their next pain appointment, their identification as a patient enrolled in Accurate Clinic’s opioid pain management program, their diagnoses and most importantly, their prescribed medications and doses. Our pain management patients are advised to present this wallet card to any other clinician providing medical care, including primary care physicians, dentists and urgent care or emergency room physicians as a means of improving safe and optimal medical care.
Currently computer software limitations prevent us from providing wallet cards to our other patients but we hope to overcome these limitations soon.
Accurate Clinic is the only health care practice in Louisiana that we know of that provides a coordinated care program such as ours.