Name of the Procedure

Prolonged Service(s) in the Outpatient Setting Requiring Direct Patient Contact Beyond the Time of the Usual Service; First Hour
Alternate Name: Extended Outpatient Visit

Summary

This procedure involves spending additional time with a patient during an outpatient visit to address complex medical issues beyond the typical duration of a standard evaluation and management service. The extended time ensures comprehensive care, including thorough assessments and detailed discussions.

Purpose

Extended visits are crucial for patients with complicated medical conditions that require more in-depth discussion, evaluation, and management. The primary goal is to ensure a high level of personalized care, accurately address complex medical problems, and develop a comprehensive treatment plan.

Indications

• Patients with multiple chronic conditions
• Situations requiring extensive history-taking and decision-making
• Thorough review of medical records and detailed planning
• Complex diagnostic evaluations
• Patients needing significant emotional and psychological support

Preparation

• Patients usually need to prepare as they would for any other outpatient visit.
• Bring all relevant medical records and a list of current medications.
• May need to complete specific questionnaires or assessments prior to the visit.

Procedure Description

1. Initial Evaluation: The procedure begins with a routine Evaluation and Management (E/M) or psychotherapy service.
2. Extended Time: The healthcare provider continues to spend additional time with the patient beyond the usual service duration.
3. In-depth Discussion: Detailed conversations include comprehensive history-taking, reviewing past medical records, and planning.
4. Examinations and Consultations: Conduct any necessary additional physical exams, diagnostic tests, or consult with specialists.
5. Development of Plan: Create a detailed treatment or management plan tailored to the patient's specific needs.

Tools and Equipment: Standard medical examination tools, patient records, possibly diagnostic equipment.

Anesthesia or Sedation: Not required.

Duration

Typically lasts for an additional hour beyond the standard visit time.

Setting

Performed in an outpatient clinic or doctor's office.

Personnel

• Primary care physician or specialist
• Nurses or medical assistants as necessary

Risks and Complications

Common Risks: Minimal since it usually involves discussions and planning rather than invasive procedures.
Rare Risks: Miscommunication or misunderstandings leading to improper management plans, which can be mitigated by thorough documentation and clear communication.

Benefits

• Comprehensive and individualized medical care
• Thorough understanding of complex medical conditions
• Detailed and well-considered treatment plans
• Potential for better overall patient outcomes

Recovery

• No specific recovery is needed as this is a non-invasive extended consultation.
• Follow the plan and any given instructions by the healthcare provider.
• Schedule follow-up appointments as recommended.

Alternatives

• Standard Outpatient Visits: May not allow sufficient time for complex cases.
• Multiple Short Visits: Can be used but may lead to fragmented care.

Pros and Cons: Extended visits provide thorough and continuous care but require more time from both patient and provider compared to multiple short visits.

Patient Experience

During the procedure, the patient should feel heard and understood due to the extended time. Afterward, patients might feel more confident in their treatment plan and care, having had ample time to address all their concerns. Pain management is generally not applicable, but efforts are made to ensure patient comfort throughout the visit.