u/RoarOfTheWorlds

It’s THE thing he’s been holding out for and I can’t imagine it should be that difficult given how big the show is. Granted I fully expect he’ll get to interview him at some point in the future, but I really would love this for Colbert.

OpenEvidence gave me the following requirements and they seem simple but something about it just feels like I am missing something important:

Required elements (all must be documented): [3]

1. Cognition-focused evaluation — history and examination
2. Medical decision-making — must support moderate or high complexity
3. Functional assessment — ADLs/IADLs (can use standardized tool)
4. Standardized dementia staging — e.g., Clinical Dementia Rating (CDR), FAST, GDS
5. Medication reconciliation and review
6. Neuropsychiatric and behavioral symptoms evaluation
7. Safety evaluation — driving, wandering, firearms, fall risk
8. Caregiver identification and assessment — caregiver needs, burden
9. Advance care plan review — or initiation of ACP discussion
10. Written care plan creation — must be shared with patient/caregiver with education and support
11. Independent historian — required (i.e., a caregiver/informant must be present or contacted)

Practical tips for making this feasible:

• Have the MA administer the standardized tools (Mini-Cog/MoCA, ADL checklist, dementia staging scale, safety checklist, caregiver burden screen) before the physician enters — this can take 15–20 min of staff time
• The physician then performs the cognition-focused H&P, reviews results, creates the care plan, and discusses with patient/caregiver — roughly 30 min of physician face-to-face time
• The work can be split across multiple visits but cannot be billed until all elements are complete

I feel like I’m pretty strong with billing and I pull in a good number of patients per day, I just know that five days a week gets really exhausting and honestly it’s so much easier for me to handle the four days on when I know I’ve got three days off.