The Follow-Up Visit – Three Reasons Why You Should Show Up
I often get questions from patients about why they need to follow up as often as they do. In fact, my own family members often remark they don’t want to follow up so often and assume this is done just to line their provider’s pockets. This couldn’t be further from the truth. The frequency of follow-up varies from patient to patient and condition to condition, but is important to make sure your plan of care is:
Some medications need to be monitored closely to make sure they don’t cause problems. For example, warfarin (also known as Coumadin) is a common blood thinner used to prevent or treat blood clots. Frequent laboratory monitoring is needed to make sure the warfarin dose is correct. If the dose is too low, there is an increased risk for blood clots; if the dose is too high, there is an increased risk of bleeding.
Another reason for follow-up is to make sure a treatment is effective. For instance, one of the most common reasons for follow-up is blood pressure monitoring. Home blood pressure monitoring is great and can give us an idea of what your blood pressure does throughout the day, but we want to make sure your home blood pressure cuff is accurate. That’s why it helps if you can bring in your cuff to compare its reading to one taken by hand in the clinic. The last thing we want is to base our treatment decisions on bad information. For example, if your home blood pressure cuff is too big, it could falsely lower your blood pressure and make us think we have your blood pressure in good control, when in reality your pressure is too high, increasing your risk of kidney, heart, and blood vessel damage.
Finally, we want to make sure your plan is tolerable. Your plan could be perfectly safe and effective, but cause a side effect that you just can’t deal with, leading you to stop the treatment plan. The most effective plan even when not followed is still ineffective, so it is important to let your provider know so adjustments can be made. If we don’t know about a side effect or that you’ve stopped taking your medication, we assume everything is going well and your condition is controlled. We can’t fix what we don’t know is broken! To go back to the last blood pressure example, some blood pressure medications can suddenly cause a dry, annoying cough even when they’ve never caused a problem before. Some patients search Google for their symptoms, determine it’s a side effect of the medication, and just stop taking it. Because high blood pressure usually doesn’t cause any symptoms until it is dangerously high, they assume that everything is fine because they feel fine. These patients could go on to have a heart attack or stroke because they stopped taking their medication, when we could have easily switched to a different medication that will be better tolerated.
Making sure we can follow up with you
Just as we want you to follow up with us, we want to follow up with you. Make sure we have your most up-to-date contact information, including address and phone number, so we can give you the results of any testing we’ve done. It’s also important to make sure your voicemail is working. We often try to call patients with results only to discover their phone number has been disconnected, or their voicemail box is full or has not been set up. Another option for follow-up is your MyChart or other patient portal account, where you can get lab results and send messages to your provider and office staff. If we have tried multiple times to reach you and still cannot, we will send a letter to your address on file with the message we were trying to give you.
If you are not sure when you are due to follow up, contact your provider. As a general rule, even if you don’t have any chronic conditions, an annual physical is recommended to make sure you are up to date on your wellness screenings and to help you achieve your health goals.