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.