[Yash]

UGH!!! I arrived 15 minutes early for my visit to my nurse practioner. My appt was for 7:15. She saw me at 8:40. Yes, I was late for work which starts at 9. Okay, I'll live with that.

I gave my adoption medical paperwork to the woman working the front office, she in turn gave it to the office manager. The office manager called me into her office and explained she couldn't have the nurse practioner fill out the forms. How could the nurse practioner (NP) know if there is any history of hereditary disease or abnormality( physical disability) or mental health? How can she answer if I have any medical conditions that would limit the applicants' ability to parent an adopted child, as asked on my homestudy medical report form. How can she certify that I'm in good health with no communicative or mental disease/disability and am able to care for an adopted child, as asked by my international agency?

In my head, I was screaming, is she for real? Are we really having this discussion? And how could she ask the NP to sign the forms when under the signature line it says doctor/physician signature?

Taking a deep breath, I explained these are the same forms signed by the NP two years for my foster care agency. I got the impression she wanted to say to me that was then, this is now, but refrained. She told me that I should tell my agency to reword their signature line with health care professional or something of that language. Because as it stood now, this would be the same as if she had a piece of paper that required the signature of a lawyer and she had her mother sign it. WHAT??!! I bit my tongue, but I was dying to ask if her mother was even in the legal field for that analogy or example to make any sense.

The office manager said when she received the test results, she would feel comfortable having the NP sign a letter saying that (sorry for the male readers) that my PAP was clear and that I didn't have any STDs or high blood pressure.

I nodded my head and I told her I would get back to her and I thanked her as I walked out of her office.

Hours later...

Once I calmed down, I called my insurance company to find a doctor. Snap! I found one that was close to my house and saw patients at 7AM. As I was making the appointment, the scheduler said, you do know the first meeting with the doctor is a consultation, then you can make an appointment and the second visit you can have a physical. CONSULTATION??!!!! What are we dating? I want a physical and for you to sign these papers that's it. UGH!

So now I'm putting in a call to speak directly to the NP.

I'm so glad you guys are hear to listen. Who know these forms were so complicated and so UN-PC?

Can the road to Layla be smooth God? Please.....

Yash

[Linny]

Our first two adoptions were done internationally. We lived overseas; and I remembered----by reading your scenario-----that we had to find an actual MD to sign and check us out...rather than the military assistant. While we didn't have to wait that long, we DID have to wait to get to one!

I'm sorry that this stupid, redundant paperwork is so taxing. (It's one of the reasons we don't adopt from the international sect anymore.) I can't understand the intensity of it; but consider this: The time that you are having to take to fill all of it out, is time that God is quite aware of. It may very well be....that the time it's taking, means that you will prepared----and so will the baby-----to bring her home w/o further hassles like this. Everything has it's time and place. Remember that, and it helps, I think.
Good luck to you. Take a deep breath and say to yourself: "This too shall pass." ((HUG))

Most Sincerely,

Linny

[Yash]

Thanks, Linny.

This too will pass. God kept me cool when the office manager was talking and helped me guard my tongue, instead of going off on her. I know it's all part of the process. And like with my son, once Layla is here this story will be an amusing tale that I won't be able to remember all of the details of.

Yash

[snaps]

Yash -

As a member of the medical profession let me apologize for some of your problems. I am a physician assistant which is equivilant to a nurse practioner. One problem is that many forms do ask for a "physician signature". For those of us other practioners it sometimes makes it illegal for us to sign forms such as these by our state laws. Also we don't want to appear as if we are trying to "pretend" for lack of a better word that we are a physician which in some cases could lead to lawsuits, etc. if anything went to court. Many times places kick out forms signed by anyone, but the MD. A lot of times agencies or organizations will accept PA or NP signatures, but have just failed to reword their forms. Usually something in writing from the agency, etc. will due saying that they will accept a PA or NP signature. One of the biggest problems is that PAs and NPs are subject to very weird laws compared to MDs. On top of that these laws vary greatly from state to state and are constantly changing.

As for the office manager - she may not know what she is talking about. I have known many office managers that do not know the ins and outs of what PAs and NPs can do or will do. Many have no ideas of the state laws. Putting in a call to the NP is the right thing to do.

Good luck and sorry if I bored you to death with all of this. I am not trying to defend the medical profession in general. Let me admit that at times there are many flaws. Hopefully though, I cleared up some of the insanity for you.

Snaps PA-C
Physician Assistant and Mommy to 7 month old domestic princess

[Yash]

Thank you, Snaps. I appreciate you responding. I completely understand the legal issues and I was willing to get something from my agency saying that it's okay for a NP to sign, but that was unacceptable. I will have to give my agency a heads up about the wording on the form as some NPs are okay with it and others aren't.

Thanks,

Yash

[SanInUtah]

Originally Posted by Yash

UGH!!! I arrived 15 minutes early for my visit to my nurse practioner. My appt was for 7:15. She saw me at 8:40. Yes, I was late for work which starts at 9. Okay, I'll live with that.

I gave my adoption medical paperwork to the woman working the front office, she in turn gave it to the office manager. The office manager called me into her office and explained she couldn't have the nurse practioner fill out the forms. How could the nurse practioner (NP) know if there is any history of hereditary disease or abnormality( physical disability) or mental health? How can she answer if I have any medical conditions that would limit the applicants' ability to parent an adopted child, as asked on my homestudy medical report form. How can she certify that I'm in good health with no communicative or mental disease/disability and am able to care for an adopted child, as asked by my international agency?

In my head, I was screaming, is she for real? Are we really having this discussion? And how could she ask the NP to sign the forms when under the signature line it says doctor/physician signature?

Taking a deep breath, I explained these are the same forms signed by the NP two years for my foster care agency. I got the impression she wanted to say to me that was then, this is now, but refrained. She told me that I should tell my agency to reword their signature line with health care professional or something of that language. Because as it stood now, this would be the same as if she had a piece of paper that required the signature of a lawyer and she had her mother sign it. WHAT??!! I bit my tongue, but I was dying to ask if her mother was even in the legal field for that analogy or example to make any sense.

The office manager said when she received the test results, she would feel comfortable having the NP sign a letter saying that (sorry for the male readers) that my PAP was clear and that I didn't have any STDs or high blood pressure.

I nodded my head and I told her I would get back to her and I thanked her as I walked out of her office.

Hours later...

Once I calmed down, I called my insurance company to find a doctor. Snap! I found one that was close to my house and saw patients at 7AM. As I was making the appointment, the scheduler said, you do know the first meeting with the doctor is a consultation, then you can make an appointment and the second visit you can have a physical. CONSULTATION??!!!! What are we dating? I want a physical and for you to sign these papers that's it. UGH!

So now I'm putting in a call to speak directly to the NP.

I'm so glad you guys are hear to listen. Who know these forms were so complicated and so UN-PC?

Can the road to Layla be smooth God? Please.....

Yash

I don't know what form your agency is using but it does seem like a broad swipe for a GP doc to sign off on.

I had a med form, a psych form and filled out an extensive medical history myself. That's 3 forms to your 1 form. Hmmmmm....maybe your agency saw it as a technicality?

bummer!!!!!!!!!!!!!

[bromanchik]

Who is your NP's supervising physician? Let him/her sign. That is what happens in my case.

[patti Daniels]

You should call the agency and ask if the NP can sign. NP can sign certain paperwork.Doctor/Physician. This does not mean they do not sign.

Hope this helps.

QUOTE=Yash]UGH!!! I arrived 15 minutes early for my visit to my nurse practioner. My appt was for 7:15. She saw me at 8:40. Yes, I was late for work which starts at 9. Okay, I'll live with that.

I gave my adoption medical paperwork to the woman working the front office, she in turn gave it to the office manager. The office manager called me into her office and explained she couldn't have the nurse practioner fill out the forms. How could the nurse practioner (NP) know if there is any history of hereditary disease or abnormality( physical disability) or mental health? How can she answer if I have any medical conditions that would limit the applicants' ability to parent an adopted child, as asked on my homestudy medical report form. How can she certify that I'm in good health with no communicative or mental disease/disability and am able to care for an adopted child, as asked by my international agency?

In my head, I was screaming, is she for real? Are we really having this discussion? And how could she ask the NP to sign the forms when under the signature line it says doctor/physician signature?

Taking a deep breath, I explained these are the same forms signed by the NP two years for my foster care agency. I got the impression she wanted to say to me that was then, this is now, but refrained. She told me that I should tell my agency to reword their signature line with health care professional or something of that language. Because as it stood now, this would be the same as if she had a piece of paper that required the signature of a lawyer and she had her mother sign it. WHAT??!! I bit my tongue, but I was dying to ask if her mother was even in the legal field for that analogy or example to make any sense.

The office manager said when she received the test results, she would feel comfortable having the NP sign a letter saying that (sorry for the male readers) that my PAP was clear and that I didn't have any STDs or high blood pressure.

I nodded my head and I told her I would get back to her and I thanked her as I walked out of her office.

Hours later...

Once I calmed down, I called my insurance company to find a doctor. Snap! I found one that was close to my house and saw patients at 7AM. As I was making the appointment, the scheduler said, you do know the first meeting with the doctor is a consultation, then you can make an appointment and the second visit you can have a physical. CONSULTATION??!!!! What are we dating? I want a physical and for you to sign these papers that's it. UGH!

So now I'm putting in a call to speak directly to the NP.

I'm so glad you guys are hear to listen. Who know these forms were so complicated and so UN-PC?

Can the road to Layla be smooth God? Please.....

Yash[/quote]

[Yash]

Hey Patti,

My agency said the NP can sign, but the office manager says the NP can't sign until the wording on the paper is changed.

[Yash]

Thanks Brenda. I will try to find out who the physician is.

Yash

[patti Daniels]

Originally Posted by Yash

Hey Patti,

My agency said the NP can sign, but the office manager says the NP can't sign until the wording on the paper is changed.

Ask to speak to the NP or the nurse. An office manager should not be answering this question. She does not have the knowledge or license to answer this question. Hope this helps.

[b4truth]

had a similar experience, yash, so i completely understand and empathize with you.
they actually made me make an appointment for an office visit even though i had a complete physical two months prior: great bp, cholesterol etc. no significant family history.
i just bit my tongue, paid an additional $30 copay to talk to the doctor for 10 minutes so she would sign the delighful paper and left. needless to say, i really don't feel inclined to be seen by her like EVER again.

oh, and insult to injury, i am a RN. she wouldn't allow me to read my own TB test, had to go back for that, too. though i had one for 2 straight years (-) my dh's doctor IN THE SAME OFFICE let me read his. hello!

just bite the tongue and remember, what doesn't kill you only makes you stronger.

[Yash]

b4truth,

You are so right. I bite my dog and then vent here to all of you guys who can understand.

Thanks,

Yash