In a message dated 11/10/99 11:06:29 PM, hidden@email-address writes:
<< With the HMO's having cut our reimbursements to the bone, our practice is
considering providing a "standard" form with immunizations and relevant
H&P for the parent to attach to whatever forms they bring in for camp and
Several years ago when I got so tired of filling out time consuming and
poorly designed forms (especially the ones with lots of little boxes) the
practice I was working for allowed me to design a generic "user-friendly"
form with their corporate information at the top. I entitled it "Certificate
of Health Examination" and tried to include everything relevant including a
space for pertinent medical history, medications to be given in school,
immunizations updated, OK's for sports (both contact and noncontact),
height/weight, and so forth and designed it so a person could run down a
checklist for the actual exam findings (checking off either "examined" or
"not examined") for eyes, ears, all the way down to scoliosis, etc along the
left margin and write any comments (regarding educational- or sports-relevant
findings, for instance) on a single line for each system/parameter that
extended to the right margin. Tried to make it as quick&dirty as possible,
to the extent of putting the names of the organ systems first, along the left
margin, and check-off spaces in the next column to the right, in order to
see organ system name we were commenting on, not covering it with our writing
hand, we being all righties). The last check-off after all the other exam
parameters was "No restrictions" (choice of yes/no/comment).
It only took about a minute to complete since the majority of physicals have
all normal findings and those kids' forms were just a row of check marks and
a signature (office staff having filled in the date, age, hgt & wgt, etc.).
I think it's important to be able to go straight from top to bottom. Filling
many spaces that go from left to right seems to take much longer and you must
write "negative" or "normal" over & over again. I never like putting lots of
information on a school form since it may pass thru so many hands and be read
by everyone from the teacher to the principal's secretary, hence the reason
for abandoning the traditional "normal"/"abnormal" dichotomy in favor of
"examined"/"not examined", and I did leave out the category "hernia" that
seems universally beloved and substituted "GU" instead (Tanner staging could
be put on this line, for sports candidates). Putting the name&address of the
practice on the top eliminated the need to stamp the form, and the person who
did the exam could check off their name from a list of docs/NPs at the
bottom, in case his/her signature was really messy and indecipherable. This
we completed and returned to schools and sports organizations, basically
declining to complete their own form. If it looked like they wanted to know
something specific and it wasn't on our form we could always write it in.
None of the physicals we put on our own form got kicked back, so it's
something to consider. It did save time and everyone liked it.
Unfortunately I can't share the specific form since I found I never saved it
to a disk, but well, you get the idea (if you're interested).
Even briefer--a big practice in my area has a half-sheet size form in which
they only say, "_____ had a comprehensive physical exam today" and only
divulge information like hgt, wgt, immunizations, medication etc., and also
include a "no restrictions" checkoff area. It goes over fine.
Stephanie Walker, RN, FNP