Guidelines & Policies for Pay Patient Services

Patients :

Any patient may be admitted under the service of an accredited consultant, whether as a private case or a house case.
Private cases are patient who are admitted under the care of a specific physician by the presentation of a written order of the physician, a referral note to the physician or by the patients' verbal expression of preference.

House cases are patients who are admitted with not written order, referral note and no preference as to the choice of a physician. These patients shall subsequently be assigned to a consultant on deck. Department policy dictates that they be assigned to accredited consultants equitably. The manner of distribution shall be made by rotation.

Medical Staff :

I. Consultants

1. Accredited physicians shall be composed of all regular and volunteer consultants who are active participants in the department's training program and patient care.
2. For house cases, consultants shall make a choice of rotation from the following options:
   1. general medicine only
   2. subspecialty only
   3. general medicine and subspecialty
3. Consultants shall go on call for 24-hours by rotation, from 7:00AM to 7:00AM the following day. Consultants who go on leave for any reason shall inform the chief resident for proper revision of the decking system
4. Consultants shall make daily rounds with the chief resident and the resident in charge on both private and house cases.

II. Residents

1. Chief Resident
   1. He/she shall be in charge of all payward patients.
   2. He/she shall cover for the resident in charge when the latter is assigned to the OPD subspecialty for the day.
2. He/she shall prepare the house case decking for general medicine, the different subspecialties and cardio-pulmonary clearances on a monthly basis.

Referrals

1. For a specific procedure: The patient shall be seen regarding the specified procedure and the charge shall be that o the procedure only.
2. For consultation: The patient shall be seen by the consultant, who shall write down his/her findings, diagnosis and recommendations. He/She is expected to see the patient only once unless he/she is called back later, for re-evaluation. The consultant shall charge only a consultation fee.
3. Combined service or co-management: The patient shall be jointly managed by 2 or more physicians. It is strongly recommended and encouraged that any of them shall voluntarily withdraw from the case if and when his/her services are no longer essential. Separate fees shall be given to each physician.
4. Temporary coverage: During a temporary absence, an attending physician may request another member to take care of his/her patient. Fees during this time period, shall be given to the second physician.
5. Transfer of service. The original physician shall cease to see the patient after his/her transfer and the physician to whom the patient is endorsed shall take compete charge of the patient's management.
6. Subspecialty referral of private cases: This shall be done to the subspecialty consultant of choice of the patient or the attending physician.
7. Subspecialty referral of house cases;

This shall be done to the subspecialty consultant on the day of admission.