TRIAGE PATIENTS TO THE RIGHT CLINICIAN
Many practices use nurse practitioners or other non-physician clinicians (NPCs) as an “overflow valve,” scheduling patients with them only when the patient’s physician is not available. This approach can improperly match patient problems to the clinician whose skills are best suited to take care of them, which can become a patient safety issue. In a perfect scenario, patients whose problems can be capably handled by the training level of an NPC should be prioritized to them, and patients with problems requiring a higher level of training should be prioritized to a physician.
To improve my practice’s ability to effectively utilize NPCs and ease patient anxiety about not seeing “their doctor,” I use three strategies:
1. Education. I consistently teach patients and staff about training differences between physicians and NPCs and the importance of proper visit pairing.
2. Brief huddles during the day. My nurse practitioner and I check in with each other to compare schedules, swap patients as needed, and provide feedback to the front desk.
3. Open door policy. My nurse practitioner knows she can involve me if she ever feels that a problem is beyond her scope. She can simply make a warm handoff to me. This happens often enough that my patients understand that our clinical partnership allows us to offer the most efficient care to them and their families.
ADDRESS PATIENT POVERTY AND FINANCIAL STRESS AS RISK FACTORS
Poverty and financial stress are known risk factors for developing numerous diseases and are barriers to patients achieving the best possible mental and physical health.1 Medical-financial partnerships can be an effective intervention. Using grant funding, we recently partnered with a local financial coaching team to help patients work toward their financial goals.
To find potential partners for your clinic, look to community resources such as university extension offices; local banks, credit unions, or Consumer Credit Counseling Foundation offices;2 or a Financial Empowerment Center through local government.3 You can also use the AAFP’s Neighborhood Navigator to search for services in your community.4 These organizations may already support community initiatives available to patients at low or no cost. Some clinics have gotten more involved by hosting tax-preparation teams in their offices, linking parents with college savings accounts, and creating referral systems to financial coaches that assist patients with budgeting, saving, debt reduction, and credit repair. If no partners are available in your community, you can integrate trained financial coaches into family medicine social work teams.
ASK FPM: STAY UP-TO-DATE ON CLINICAL LABORATORY GUIDELINES
What Clinical Laboratory Improvement Amendments (CLIA) program changes are forthcoming in 2026?
The Centers for Medicare & Medicaid Services (CMS) announced that after March 1, 2026, notifications, fee coupons, and CLIA certificates will only be available electronically.1 You must actively switch to electronic notifications by providing written notification to your state agency via email or by completing the CMS-116 form. If your email notification is not updated or maintained, you may miss when your laboratory’s CLIA certificate is due for renewal. We recommend using a business email or one that many staff can access.
Reference(s)
- 1.Clinical Laboratory Improvements Amendments. CMS. Accessed June 9, 2025. https://www.cms.gov/medicare/quality/clinical-laboratory-improvement-amendments
