Staffing Patients
Precepting Patients: The Who, When and How
Always Precept
The following patients should always be precepted at the time of visit (regardless of year of training).:
OB Visits
OB visits
Medicare patients
If billing anything other than a 99212 or 99213, the patient must be physically seen by an attending
This includes OMT and/or any procedures
Anybody you are considering admitting or sending to the ED
R1s
Precept all patients throughout the entire year.
Attendings are required to personally see every patient for the first 6 months of training
They will still see patients personally with the resident after 6 months as needed
R2 and R3s
R2s
Beginning of the year: 75% of patients
End of the year: 50% of patients
R3s
Beginning of the year: 50% of patients
End of the year: 25% of patients
The above are general guidelines and it sometimes depends on the day how much precepting is needed, especially as you advance further into your second and third years. Know that your attendings like to teach! And, you only have three years of learning here in the residency (it does go by fast!) so feel free to precept as many patients as you would like during 2nd and 3rd year.
Tips for Smooth Precepting on Busy Days (R2s and R3s)
Consider keeping track of your clinical questions that come up on patients you don’t feel a need to precept at the time of the visit. You can run these questions by your attending at the end of the half day to get their take on your decision making. This can be a good way to learn some pearls from your attending and might give you insight into different ways to manage some more common conditions.
Consider precepting by giving a short one-liner on more straightforward patients and then asking your most pressing one clinical question. This can focus the precepting session on busy clinic days.
Always know that you can make your preceptor aware of your time constraints and asking for them to shorten the precepting session if you’re running behind. This can help a lot on busy clinic days. We all know how busy clinic can get and we want to help however we can.
Also know that you can ask your preceptors for help at any time with general clinic workflow questions. We are here to help and if we don’t know the answer we can almost always find someone who does.