Digestive Health Associates

Southwest Endoscopy Center

Midlevel Provider Protocol


1. Accepted standard of care for reference in caring for patients: UpToDate online medical reference (uptodate.com).
2. Midlevels perform independently for the following:
     a. Seeing patients for new patient and follow up visits in DHA offices.
     b. Obtaining and documenting informed consent for procedures and treatments.
     c. Ordering relevant medical tests for patients.
     d. Prescribing/dispensing medicines appropriate to patients’ GI/liver issues.
     e. Effecting referrals to other specialists.
     f. Billing for services rendered according to accepted practice.
3. Physician supervision of midlevels revolves around:
     a. Physician review of ‘assessment and plan’ portion of all chart notes for patients seen by midlevels, referring to other portions of chart note as needed.
     b. Quarterly meetings with all midlevels and all physicians who are in town on that date in attendance. Midlevels’ questions are solicited with educational development encouraged.
     c. Midlevel attendance of Southwest Endoscopy Center (SEC) CQI meetings as desired by midlevel or requested by SEC physicians.
     d. Frequent informal discussion of cases with physicians, via direct conversation or e-mail/EMR ‘telephone tasking,’ is welcome.  If the physician assigned as attending physician for a case (i.e. assigned review of midlevel’s chart note for this case) is not immediately available, contacting one of the other physicians for input is appropriate.