News Headlines Article

When Patients Don’t Follow Up
The New York Times

Several years ago, I saw a woman with unexpectedly high blood pressure. Her readings were as high as 140/110, way above the normal value of 120/80. Though she was otherwise healthy, she was at risk of a stroke.

Because extreme hypertension in young women can be caused a blockage of an artery to the kidney, I scheduled an M.R.I. within in a few weeks. But she never had the test or followed up with me.

Patients frequently miss appointments and tests that their doctors schedule. No-show rates range from 5 to 55 percent. In some instances, like when a patient skips a cardiac stress test, for example, then has a heart attack, the hospital might classify what occurred as a “systems error.” Ideally, such cases lead to new policies that prevent similar events.

But what about less drastic cases, in which follow-up is necessary but not an emergency? Should patients be held responsible for not showing up? Or does the medical profession have an ethical and legal duty to try to track down the individuals?

Commands