Dear Trish, KEMH in Perth has a system in place that seems to be working.
Maybe one of the midwives on the list will reply with more information,
regards, mary murphy
----- Original Message -----
From: Trish David <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Thursday, September 09, 1999 10:54 AM
Subject: ordering of tests
> Dear all
> I know i have put this request out to you before, but am in need of more
> specific information, and there may be some of you who have got further
> down the track than we have.
>
> I have put forward (with the help of some colleagues) a protocol for
> midwives ordering routine tests for the pregnant and birthing women they
> have all but sole care of. Teh medical men and admin are in agreement
that
> this is a sensible thing to hasten slowly on. We have hit a stumbling
> block, however with our director of pathology services who says we cant
get
> paid for tests that midwives order. All forms must have a doctor's
> signature on them. I find this difficult to believe, as many of these
> doctors only can order tests within the hospital environment anyway, so
> cannot have full provider numbers necessary for such re-imbursement. As
> this is covered by the medicare act (in my understanding) and this is a
> federal rather than state law, and as other hospitals are doing this sort
> of thing (and thanks to KEMH and Alice Springs for info so far) I know it
> can be done. It is unlikely these places are doing it for nothing!!!
>
> So, my request is for the actual mechanics of the process. I need to know
> how you are re-imbursed for tests ordered by midwives (and nurses if
> applicable), what protocols allow this, eg standing orders, using your
> pathologists provider number just like interns do, etc. It is my
> understanding that this responsibility can be delegated, it is just a
> matter of will on the part of those 'at the top'.
>
>
> On another matter, i sat in a meeting hte other day where it was said the
> hospital needed to put a friendlier face on for women who had chosen
> homebirth, but who were also booking in to hospital 'jsut in case'. I
> suggested allowing full visiting rights for their midiwves as the
> professional responsible. Teh answer was that it was looked at some time
> ago, but could not occur as other than a support role becuase of
> medico-legal reasons. Now I know this is probably a furphy. But I would
> love to have evidence from other centres that this is the case, that
> midwives can have visiting/admission priveleges without posing a
> medico-legal risk to hospitals or obstetricians. So, if you are willing
to
> share, I would like copies of policies, pro forma contracts, etc, so I can
> get moving on this (AGAIN) down here. I think the wind is in the right
> direction for a change, and I want to ride it.
>
> Cheers, Trish
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