I have the privilege of working in a really nice community office.  I’m a family physician working for Big University Hospital.  As you would expect, our practice location has a modern emr, we have clean floors and fresh paint.  We are always well stocked with supplies, etc. , etc.  You can imagine my chagrin when I was forced to tell a patient this morning that we could not place her Nexplanon (implantable birth control) because I didn’t have the ability to run a pregnancy test.  Our clinic has a fancy new ultrasound machine, we do all manner of in office procedures; if there is one test that is absolutely vital to running a functioning clinic, it’s the ability to run a pregnancy test!  Oy vey!  We sent a blood sample to the lab and had her come back in the afternoon.

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