PAC Notes: Taxonomy Section I Part II

Last Updated on April 16, 2022 by Lee Burnett, DO, FAAFP

NATIONAL PROJECT ON THE COMMUNITY BENEFITS

OF FAMILY PRACTICE RESIDENCY PROGRAMS

CUMULATIVE QUESTIONNAIRE RESPONSES

Taxonomy Section I Part II

Reviewed by Policy Analysis Committee 4-11-05

San Diego, California

The following two questions are from the Second National Workshop’s Questionnaire (2002, Louisville).  The recorded responses to these open-ended questions identified various “specialty clinics” operated by various residency programs, which were replaced by forced choice questions on such specialty clinics.  Subsequent iterations of this original question have led to a series of questions about specific medical and surgical interventions by specialty:

SD I.13 (L32) Does your residency provide specialty care?

SD I.13a (0) If yes, list these services in approximate order of volume or revenue.

The following question was derived out of the responses to the SD I.13 (above).  This format was followed for each selected specialty in the Site Survey Questionnaire administered during the first group of 2004 site visits:

SD I.13a(1) (L32) Does your residency program provide the following kinds of specialty care?  Sports Medicine? Yes __ No __ 

If yes, are these services provided during special clinics? What is the number of patients seen? What are the revenues that are generated?

The following series of questions displays the current format of the “specialty” questions.

Dr Nalin volunteered to review the wording of the following set of questions and each similar group of questions throughout Taxonomy Section I,, and to propose modifications, to include the elimination of the term “kinds of specialty care”, and to eliminate the potential ambiguity of mixing the questions “does your residency program provide” and “do you provide” in the same sequence of questions.

Dr Nalin and Dr Zollinger of Indiana University agreed to conduct an analysis of the series of questions on Sports Medicine, Fracture Care and Orthopaedics.

SD I.13a(1.1) (SD I.13a(2) (L32)) Does your residency program provide the following kinds of specialty care?  Sports Medicine? Yes __ No __ 

It was the consensus of Policy Analysis Committee Breakfast Group W (Clasen, Eastman, Pugno, Ross, Wilke and Zollinger) that the iterative phrase “provided as normal family health center appointments” should be replaced with the questions “are they provided in your center?” or “are they referred out?”.

SD I.13a(1.2) (SD I.13a(3)) If you do provide sports medicine, are these services provided as normal family health center appointments? Yes __ No __

It was the consensus of both Policy Analysis Committee Breakfast Group V (Bradley, Burnett, Henley, Nalin, Rodos and Wright) to eliminate from future Site Survey Questionnaires the revenue and productivity questions relating to any special clinics operated by family medicine residency programs.   This type of question in the future would be asked only as part of focused studies, with the objective of obtaining precise answers.

It was the consensus of Policy Analysis Committee Breakfast Group W that the current iterative questions on “special clinics”are less important than “do you offer this service to the community?” and “is it performed or supervised by family medicine residency faculty?”

SD I.13a(1.3) (SD I.13(4)) If you do provide sports medicine, are these services provided during special clinics? Yes __ No __

 If yes, what is the number of patients seen?  What revenues are generated in each specialty service?

The following set of specialty questions in Sports Medicine was developed by Dr Charles Henley at Oklahoma University, Tulsa, after review of the cumulative responses.  These questions are planned to be asked in the Second E-mail Questionnaire:

*SD I.13a(1.31) (CEH) Do you have an acknowledged, separate entity in your department or within your residency program designated as “Sports Medicine”? Yes __ No __

*SD I.13a(1.32) (CEH) Does your department or residency program sponsor Sports Medicine Fellows in a defined program of study? Yes __ No __

*SD I.13a(1.33) (CEH) Has your department or residency program designated a faculty member as the head or director of Sports Medicine?

Yes __ No __

*SD I.13a(1.34) (CEH) Is there a separate facility for Sports Medicine?

Yes __ No __

*SD I.13a(1.35) (CEH) Does your Sports Medicine program affiliate with a college sports team or athletic department? Yes __ No __

*SD I.13a(1.36.1) (CEH) Does your Sports Medicine program incorporate the following:

a) Physical therapists? Yes __ No __

*SD I.13a(1.36.2) (CEH) Does your Sports Medicine program incorporate the following:

b) Occupational therapists? Yes __ No __

*SD I.13a(1.36.3) (CEH) Does your Sports Medicine program incorporate the following:

c) Referral Clinic Yes __ No __

*SD I.13a(1.36.4) (CEH) Does your Sports Medicine program incorporate the following:

d) Casting? Yes __ No __

*SD I.13a(1.36.5) (CEH) Does your Sports Medicine program incorporate the following:

e) Splinting? Yes __ No __

*SD I.13a(1.36.6) (CEH) Does your Sports Medicine program incorporate the following:

f) Taping? Yes __ No __

*SD I.13a(1.36.7) (CEH) Does your Sports Medicine program incorporate the following:

g) Fracture Management? Yes __ No __

*SD I.13a(1.36.8) (CEH) Does your Sports Medicine program incorporate the following:

h) Nutrition Counseling? Yes __ No __

*SD I.13a(1.36.9) (CEH) Does your Sports Medicine program incorporate the following:

i) Lecturing to community groups? Yes __ No __

The following two questions are successive iterations of open-ended questions on the range of services by specialty.  The latter question was added with Dr Henley?s sports medicine questions:

SD I.13a(1.4) (SD I.13a(5)) Describe the kinds of sports medicine care that typically takes place within the family health center (whether as normal appointments or during special clinics):

*SD I.13a(1.41) (SD I.13a(5.1)) Describe any other kinds of sports medicine care that typically takes place within the family health center (whether as normal appointments or during special clinics):

This iteration of questions on fracture clinics and fracture care was derived from responses from the original Louisville question.

The fracture care questions and responses are being reviewed by Doctors Nalin and Zollinger of Indiana University.

SD I.13b(1) (L32) Does your residency program provide the following kinds of specialty care?  b. Fracture clinic? Yes __ No __ Additional Info:

If yes, are these services provided during special clinics? What is the number of patients seen? What are the revenues that are generated?

*SD I.13b(2.1) (SD I.13b(2) (L32)) Does your residency program provide the following kinds of specialty care?  b. Fracture care? Yes__ No __

*SD I.13b(2.2) (SD I.13b(3)) If you do provide fracture care, are these services provided as normal family health center appointments? Yes __ No __

*SD I.13b(2.3) (SD I.13b(4)) If you do provide fracture care, are these services provided during special clinics? Yes __ No __

If yes, what is the number of patients seen?  What revenues are generated in each specialty service?

The following set of specialty questions in fracture care (the questions whose numbering begins with SD I.13b) were developed by Dr Pugno, after review of the cumulative responses.  Almost all of these were asked in the First 2005 E-mail Questionnaire. 

*SD I.13b(2.31) (PP) Do you perform initial evaluation of extremity injuries within your family medicine center? Yes __ No __

Question SD I.13b(2.32) on X-rays of potential extremity injuries was excluded inadvertently, but is planned to be incorporated within the Sports Medicine Questions for the Second E-mail Questionnaire:

*SD I.13b(2.32) (PP) Do you provide interpretation of X-rays of potential extremity fractures within your family medicine center? Yes __ No __

SD I.13b(2.33) (PP) Do you provide splinting and casting services within your family medicine center? Yes __ No __

Because responses to the “splinting and casting” question revealed that some programs do splinting, but not casting, the question was divided for subsequent Site Survey Questionnaires. Parallel questions, asking discrete questions on splinting, casting and taping occur in Dr Henley?s Sports Medicine questions (see above):

*SD I.13b(2.33.1) Do you provide splinting services within your family medicine center? Yes __ No __

*SD I.13b(2.33.2) Do you provide casting services within your family medicine center? Yes __ No __

*SD I.13b(2.34) (PP) Do you take care of non-displaced, closed fractures within your family medicine center? Yes__ No__

*SD I.13b(2.35) Do you perform selected closed reductions of the extremities within your family medicine center? Yes __ No __

*SD I.13b(2.36) (PP) Do you evaluate and manage clavicular fractures within your family medicine center? Yes __ No __

SD I.13b(2.4) (SD I.13b(5)) Describe the kinds of fracture care that typically take place within the family health center (whether as normal appointments or during special clinics):

*SD I.13b(2.41) (SD I.13b(5)) Describe any other kinds of fracture care that typically take place within the family health center (whether as normal appointments or during special clinics):

This iteration of questions on orthopaedic care was derived from responses from the original Louisville question.

The orthopaedic care questions and responses are being reviewed by Doctors Nalin and Zollinger of Indiana University.

SD I.13c(1) (L32) Does your residency program provide the following kinds of specialty care?   c. Orthopaedic clinic Yes __ No __ Additional Info:

If yes, are these services provided during special clinics? What is the number of patients seen? What are the revenues that are generated?

*SD I.13c(3.1) (SD I.13c(2) (L32)) Does your residency program provide the following kinds of specialty care?  c. Other orthopaedic care Yes __ No __

*SD I.13c(3.2) (SD I.13c(3)) If you do provide orthopaedic care, are these services provided as normal family health center appointments? Yes __ No __

*SD I.13c(3.3) (SD I.13c(4)) If you do provide orthopaedic care, are these services provided during special clinics? Yes __ No __

If yes, what is the number of patients seen?  What revenues are generated in each specialty service?

*SD I.13c(3.31) (PP) Do you evaluate and manage back pain within your family medicine center? Yes __ No __

*SD I.13c(3.32) (PP) Do you treat osteoarthritis within your family medicine center?  Yes __ No __

*SD I.13c(3.33) Do you perform joint aspirations within your family medicine center? Yes __ No __

*SD I.13c(3.34) (PP) Do you treat tendonitis within your family medicine center?  Yes __ No __

*SD I.13c(3.35) (PP) Do you evaluate and manage carpal tunnel syndrome within your family medicine center? Yes __ No __

*SD I.13c(3.36) (PP) Do you routinely refer carpal tunnel syndrome patients to orthopaedics?  Yes __ No __

SD I.13c(3.4) (SD I.13c(5)) Describe the kinds of orthopaedic care that typically take place within the family health center (whether as normal appointments or during special clinics):

*SD I.13c(3.5) Describe any other kinds of orthopaedic care that typically takes place within the family medicine center:

Dr Henley of Oklahoma University, Tulsa agreed that to conduct an analysis of the following series of questions on Osteopathic Manipulation Therapy:

SD I.13c(4.0) (SD I.13r (1) (L32)) Does your residency program provide the following kinds of specialty care?   r. Osteopathic Manipulation Therapy?

Yes __ No __ Additional Info:  If yes, are these services provided during special clinics? What is the number of patients seen? What are the revenues that are generated?

*SD I.13c(4.1) (SD I.13r(2) (L32))  Does your residency program provide the following kinds of specialty care?  c(4). Osteopathic Manipulation Therapy?  Yes__ No __

*SD I.13c(4.2) (SD I.13r(3)) If you do provide osteopathic manipulation therapy, are these services provided as normal family health center appointments? Yes __ No __

*SD I.13c(4.3) (SD I.13r (4)) If you do provide osteopathic manipulation therapy, are these services provided during special clinics? Yes __ No __

If yes, what is the number of patients seen?  What revenues are generated in each specialty service?

Last Updated (11 June 2006 13:02)

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