The Jefferson Pulmonary & Critical Care Division is located in the sixth floor of Walnut Towers building in center city Philadelphia, a block from the main hospital. The academic offices of the division with attendings, fellows, and conference room is co-located on the same floor as the patient exam rooms, PFT lab and in the same building as the sleep center and complete chest radiology services.
A new PFT lab will have complete pulmonary function testing capacity including:
- body plethysmography
- methacholine provocation studies
- cardiopulmonary exercise studies
- 6 minute walk studies
There are eight exam rooms and patients are seen five days a week. There are currently 2 medical assistants, a physician extender, and a respiratory therapist. The space is easily accessible for both patients and employees by an attached garage.
In the outpatient practice, we provide consultative care and most patients already have a general or primary care provider who is the "quarterback" for the patients' overall care. Typically patients are referred by a primary physician for a specific respiratory symptom, radiographic abnormality, or unknown disorder. The consultation maybe for initial evaluation and diagnosis, for PFTs, bronchoscopy, for characterization of severity and clinical course, and for initial therapy. The pulmonologist typically works closely with the patient's primary care provider. Of course, a patient does not need a formal referral by a physician to be seen in the pulmonary clinic. In general, the detailed impressions and recommendations from an initial visit is promptly shared with the referring doctor and arrangements are made regarding further care and issues of co-management.
In a typical office visit, all prior outside records are reviewed, a detailed history and examination is obtained from the patient (and family). Typically we perform a chest x-ray and breathing measurements in the office on the initial visit (unless the patient brings a copy of recent studies). The office breathing measurements (pulmonary function studies or spirometry and other measures) are fairly simple and routine. If you are on breathing medications let your nurse know prior to the study. See the PFT link for further details.
Based on the specific reason for the consultation, some patients may undergo additional testing including a bronchoscopy. This is a procedure that is performed under "conscious sedation" with a major goal to inspect the breathing tubes, obtain specimens, etc. See the bronchoscopy link for further details.