Originally Posted by Unregistered

Can I ask for some advice as a new mopex in ops (started jul this year). I have 3 main enquiry.

1) is it true that sometimes our consult is purely just about helping navigating the healthcare system or administrative in nature? (Given that we are the only route to subsidized care). A few examples
A) I had a healthcare worker (fellow hospital doctor) who did a screening test and ferritin is noted to be high. He said that he have already liased with the relevant specialist (haem and gastro) and just need the referral straight (so he can subsidized care)
B) another pt brought her 4 year son to see gp for abdominal pain. Gp referred him to paeds Surg as he found a left inguinal hernia. I examined pt, I don't find any hernia and the abdominal pain has resolved.

These are 2 examples I can remember among many others who come asking for referral because their gp told them to. Pt came as they want subsidized care.
Another huge group is those pts coming to ask for screening (e.g fbc/kidney function, left, tft, etc) even though they have NO symptoms.

Just checking in such cases, do we simply acede to their request, or do we have to reassess the cases ourselves?

2) this is regarding clinical consultation and our documentation. Do we have to clinically assess/examine and document all the presenting complaints that patient mentioned? (As most pple know ops pts tend to have multiple complaints). For example,
A) pt come in review of their chronic disease which is stable, but towards the end of consult complained about knee pain with no preceding trauma. He can still walk normally and there is no swelling/effusion from a quick glance.
- Can I just reassure him with some painkillers, basic advice about activity modification (as most common cause is OA), and return advice. (But without taking a full history and doing a full knee exam, and without documenting anything about the knee pain)

B) other typical case is urti pts for example. Most of them complain about fever, headache, and generalized tiredness/lethargy. Most cases, we can attribute that to the urti and the viral illness itself. In such cases, are we still expected to do a Neuro exam, take a brief history of the headache, and document all these down? And of course the tiredness as well, taking a hx will probably take up at least 5-6 min lol.
- to be fair, most documentation is templated nowadays, but definitely the consult will be longer if we start doing these things.

3) this is about documentation of return advice.
- do people actually write down exactly all the things they tell pt to look out for
- I usually just write "return if symptoms not better/worsening, unwell or any concerns/any parental concerns (for kids)
- I assume this should cover most things from a medicolegal perspective right? (Of course depending on the acute complaint, the exact thing I tell pt can differ, but there is no way to create a template for all the specific return advice)

Sorry know it's a bit strange to ask these here, but I find it a bit awkward to ask these questions to my hod/seniors in ops, especially since I don't know them well. You are usually alone in a consult room in ops, there is no reg like in hospital setting (usually in hospital, mos like myself direct these queries to the team reg)