Blog | Friday, August 23, 2013

'See you in a Coupla Years ...'

A couple of years ago I blogged about my friend's Grandma. She was 93 and had been to see her eye doctor. Things checked out well during her eye exam, so he told her to "follow up with me in two years."

The point of the post (beside the unbridled optimism) was that there's no science on when patients should follow up with doctors. We have rules of thumb, like "annual physicals" that the culture, for better or worse, buys into.

Patients that have chronic conditions like diabetes are often urged to see health pros on a quarterly basis, to check labs (seeing if their average blood sugars have been near normal or not) and get their blood pressure checked. That's four visits per year.

How often do you see your doctor/NP/PA?

If you feel well, and you're a minimalist, your answer might be "as little as possible." (Call that the Hartzband viewpoint.)

If health concerns make you anxious, or you need the peace of mind of knowing that a health professional has evaluated your concern, then you may come more often. (Call it the Groopman approach.)

So, at heart are you a Hartzbander or a Groopmanian?

Dentists, it seems, have locked in the idea of two visits per year for preventive/maintenance oral care.

One tradition that dictates much of the health care economy is that folks with chronic conditions are told specifically when to come back, or asked to make an appointment at some set interval. Though done with good intentions (so that patients aren't "lost to follow up," and conditions can be monitored), there's no denying that mandatory follow ups make a good core business for medical practices. It keeps 'em coming ...

So my friend's Grandma, now 95, returns for her two-year follow-up. Eyes are still good. Doctor wants to schedule a follow up in another two years. "Ninety-seven year olds don't have two year calendars," she quips.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.