As soon as Mom arrives with more than one child for a visit scheduled for one child, the receptionist asks Mom how all the other children are in an upbeat, conversational voice. If Mom makes any reference to any of them not feeling well, the receptionist can offer several options (based on some policies and procedures you agree upon). 1. Offer to do his/her best to fit the other children in to the schedule. Lets Mom know that a separate child is a separate visit. You have a few minutes notice to get the chart. 2. Offer to make an appointment at another time. Probably less appealing to Mom than #1 (well, most appealing to Mom would be to get in the exam room with you and the rest of the kids without ANY of this fuss, but... <g>), it nevertheless is a quick response to her needs and also reinforces that this is a separate visit and you need some preparation time. 3. Offer to have a nurse or PA see the other child while you are seeing the scheduled child. Assure Mom that you will be consulted and involved, although less directly. People generally respond better to being offered options (even if none of them are exactly what they want) more than being told what can be done without any negotiation possible. As a general strategy, go over your last six months of schedules and determine the frequency with which this happens. If possible, track the data by morning and afternoon, even better in one hour segments. Determine if there is any pattern, such as day of the week, morning afternoon, etc. Then reserve slots in the schedule for these two-fers in the same way you leave some slots open for urgent calls. This doesn't solve the chart problem completely (although you still get a clue when Mom first arrives and have a bit of prep time) but will reduce chaos and make your life a bit less crazy. Best regards, Bill Braun At 11:17 PM 7/16/97 -0500, you wrote: >We've all had this happen- I'm just wondering if anyone has come up with a >brilliant way of handling it: Mrs Smith brings Billy-Bob in for a sick >visit. You have his chart only. Nurses have asked her if any of the other >children need to be seen and she has said no. After you finish with >Billy-Bob, mom asks if you would mind looking at Jim-Bob's ears because he >didn't sleep well- and since you're still in the room how about Joe-Bob's, >Bubba's and Sissy's. You know you have to write notes to remember who had >the effusion and who's myringotomy tube was in the canal so when mom calls >you a few days later to say that the " not infected ear" I had looked at >was now draining pus....... you could come up with an intelligent plan. OK >- maybe I'm exaggerating a wee bit-- but I don't think East Texas has the >corner on two for one sibs. How do you handle this? --------------------------- Medical Practice Systems Inc. (216) 382-7111 (Voice) and The Health Systems Group http://www.hlthsys.com Mergers - Planning - Management Services Marketing - Managed Care - Education & Training