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hematologists or other physicians. Patients are put into the difficult
situation of collecting records or getting surgical clearances under
serious time constraints; they want to ensure that their surgery
occurs as scheduled.
These medical clearance concerns, whether they be hematologic,
cardiac or otherwise, require your critical attention. Patients who
have a blood disorder or cardiac condition, or have an immediate
family member with such a condition, must have a proper clearance
before surgery. In hospitals, this is often less of an issue because med-
ical specialists are located in the same building, making it easy to
coordinate consultations and testing. However, for an ASC this can be
more difficult to manage.
You should have a clear protocol for obtaining all required medical
clearances. In the case above, the hospital's procedure for obtaining
the clearance was not rigorous and there was no process in place to
assure that required proper consultation had actually been obtained.
After scheduling a patient's surgery, it's essential to communicate
your expectations for clearance, and give the patient enough time
to collect records and visit any specialists. Try to avoid placing
unnecessary pressure on the patient to obtain the records, and
whenever possible, have releases signed in order to obtain the
records yourself. When a patient does obtain the documents from
the specialist, you want a recently written letter clearing the patient
for that specific surgery. Notes in side margins, over-the-phone
agreements or years-old records will not cut it.
If a patient is having trouble obtaining the records, or if you're
receiving incomplete or outdated forms, you should personally
reach out to the specialist. You also want to personally check with
the specialist if there is any concern that the patient may be
M E D I C A L M A L P R A C T I C E
