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Patient Follow-Up: What Doctors Can Learn From Dentists

I have to give my dentist credit. He and his staff know when I am due for a cleaning and call me to schedule an appointment without fail. They also call to remind me the day before an appointment. Many dentists, I understand, do similar kinds of things for their patients.

As a patient, I like being reminded — it’s a great service. I also like the fact that someone’s looking out for me. From a business perspective it makes a lot of sense as well. Fewer “no shows,” more cleanings, more billings, and so on.

It’s too bad that more physicians don’t routinely follow up with their patients, particularly when it really counts.

Take the example of 172 patients in a 2008 study by Maniaci et al., of patients discharged from the hospital with a new medication. Within 3 days of discharge, patients were surveyed about what they “knew” about their new medication based upon what their attending physician told them.

According to the study:

  • 36% of patients did not know the name of the medication they were given.
  • 36% of patients did not know what the new medication was supposed to do.
  • 44% did not know the proper dosage instructions for the new medication.

If this is representative of the quality of physician discharge instructions at most hospitals, is it any wonder that 20% of Medicare hospital discharges end up being re-admitted to the hospital within 30 days — and 34% after 90 days post discharge?

Remember that medical errors are a frequent cause of action in malpractice cases. Poor physician-patient communications about new medications at the time of discharge, follow-up tests, follow-up with their primary care physician, etc., are examples of common medical errors.

In a similar study, Kripalani et al., found that almost 50% of patients sent home with a new medication experienced some degree of medication non-adherence in the 2 weeks following hospital discharge. When patients in the study were asked what could be done to improve medication use, almost 70% said a follow-up phone call to review medication would be helpful.

Why can’t physicians be more like dentists when it comes to proactively following up with patients?

REFERENCES:

Maniaci et al. “Functional Health Literacy and Understanding of Medications at Discharge.” Mayo Clinic Proceedings. 2008.

Kripalani et al. “Medication Use Among Inner-City Patients After Hospital Discharge: Patient-Reported Barriers and Solutions.” Mayo Clinic Proceedings. 2008.

*This blog post was originally published at Mind The Gap*


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