Narcisse asks about specialty referrals; Long explains e-consult triage

Specialty.

Yeah.

Let's say they come from another doctor and they know specifically what's wrong.

And to see a specialty.

And after their enrollment, how long you be, let's say a GI or cardiologist, how the process goes.

Great question.

So this is something that yesterday the answer probably would have been simpler before the program existed where you just would have a referral and you'd get into the queue.

We've completely changed that.

So the way it typically works now is if you

get seen somewhere else, let's say you go to the emergency room and you're told to come to the health and hospital, something like that, you'll come through the front door of primary care.

So I see patients all the time that were referred from a specialist outside the system or went to the emergency department or had an admission and then were referred to us.

I will then see them, evaluate them, and what we do for specialty care now, which is way more effective than the system we had before, is we have something called e-consult.

So basically, let's use an example.

If you're having a racing heartbeat or something, I can ask that question via e-consult to the cardiologist.

And the cardiologist, so you're not just going to get put into a queue regardless of being triaged.

They're going to actually triage and say, okay, I would like to see this patient in seven days, in three days, in 14 days, in 30 days.

So the specialist is already having a role in triage before your appointment's even booked.

That makes it so that if you have more of an urgent issue, we'll get you in more quickly, and the specialists are involved from day one after that referral is placed.

A lot of times, too, what happens is...

You may have been referred to us.

I'll give another example here.

A patient, this was a long time ago, with a mass in their wrist.

I got the x-ray.

There was a concern.

The read of the x-ray was concerning for a potential, you know, it was listed as a growth.

Growth can mean cancer.

That's very scary.

But I sent the e-consult, and the patient wasn't even triaged to be seen.

It was just answered, oh, it's normal.

So the patient didn't even have to worry about seeing ortho.

So e-consult not only gives us, and statistically it's about one out of every five.

patients gets the answer within a matter of hours from the specialist so that they don't even have to wait for the appointment.

But everybody else gets their specialty appointments based on the urgency that's defined by the specialist that will be seeing them.

I'll add to that briefly, just that the point, I think, for our patients and for all New Yorkers is just get their problem taken care of, wherever it is, whether it's a cardiologist or a primary care doctor.

And what's happening now is I feel well supported as a family doctor.

I have all the specialist's knowledge at my fingertips to take care of that problem right there and then where the patient is.

I think usually when patients are asking for a cardiologist or an ENT, they think they need that.

To get the problem taken care of, but often a primary care doctor can do it with the right support, and that's what we're doing right now.

I agree.