RNonWheels

You just finished a Start of Care. You’ve identified several critical medication changes that need clarification. You’ve left a voicemail, faxed the orders, sent a message through the portal… and nothing. Hours go by. The patient needs care, but you’re stuck.

This scenario plays out daily for home health RNs — and it delays care, increases liability, and clogs your schedule. The good news? There are strategies to get MD responses more reliably and document your efforts properly.

🧠  Why MD Communication Breaks Down

• Busy clinic schedules → MDs don’t check messages until end of day
• Layers of gatekeepers (front desk, MAs, fax queues)
• No clear escalation pathway
• Lack of standardized communication templates
• Fragmented EMRs (especially between hospital → SNF → HH)

📞  Pro Strategies to Get MD Responses Faster

1. Lead with the Most Critical Info (SBAR Style)

• Use SBAR (Situation, Background, Assessment, Recommendation) when calling/faxing.
• Example fax header:Situation: Critical med clarification needed for patient starting home health today.
  Recommendation: Please sign attached order for Lasix dose clarification.

2. Use Fax + Phone Together (Don’t Rely on One)

• Fax the order with a clear “Requires Signature — Fax Back to ###” banner.
• Then immediately call the office and say:“Hi, this is [Name], RN with [Agency]. I just faxed a time-sensitive order for [patient name]. Can you please flag it for the MD to review today?”
• Ask for the MA’s direct line or secure message contact if possible.

3. Build Relationships with Office Staff

• Learn names of key MAs or front desk contacts for frequent MDs.
• Be kind, professional, and consistent — they’re your best allies.
• A good relationship can turn a 3-day fax turnaround into a same-day signature.

4. Give Specific Timeframes

Instead of “call back when available,” say:

“Can we get a response by noon so we can proceed with care today?”

This sets expectations and gives you documentation if the response is delayed.

5. Know When & How to Escalate

If attempts fail:

• Notify your clinical manager or MD liaison.
• Document every call, fax, and message with time/date.
• Follow agency escalation protocols if patient care is impacted.

📝 Document, Document, Document

Medicare reviewers look for clear, time-stamped communication attempts. Protect yourself by:

• Logging each attempt in the chart.
• Saving fax confirmations.
• Documenting staff names and times of calls.
• Escalating when appropriate.

🧰 Bonus Pro Tips

• At SOC, ask patients which MD communication method works fastest (some prefer portals, others fax).
• Keep a “frequent MD contact sheet” in your bag for common offices.
• Ask office staff their best times to reach the MD.
• Use agency-approved electronic order systems when possible to bypass fax delays.

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🏁 Conclusion

You can’t control a physician’s schedule, but you can control how you communicate, document, and escalate. By combining structured communication (SBAR), strategic fax + phone follow-up, relationship-building, and time-bound requests, you’ll get orders signed faster — and reduce wasted time waiting by the phone.