When physicians see patients in their office for a particular issue, how soon should patients come back for a follow-up visit? Arriving at such a time frame has more to do with the art than science of medicine, contends a recent commentary in the Washington Post, which also examines how cost factors into visit frequency.
"The broader trend toward evidence-based practice in medicine hasn't quite caught up with the basic question of how often to see your doctor," writes Ishani Ganguli, M.D., an internist at the Ambulatory Practice of the Future and a fellow in health policy and management, both at Massachusetts General Hospital in Boston. "With appointments harder and harder to come by, medical costs still rising and a long-standing problem of both overuse and underuse of healthcare in the United States, doctors ought to pay closer attention to how and how often we ask patients to see us."
To date, visit rates vary wildly, according to Dartmouth research cited by Ganguli. The analysis of Medicare data found, for example, that seniors in Grand Forks, North Dakota, average less than three visits each year, while those in East Long Island, New York, go to the doctor as many as 12 times a year. Although patient acuity and physician concentration appeared to lead to more visits, patient preferences appeared to play little role.
Ganguli offered the following ideas for determining the "right" number of visits:
- Discuss with other doctors how often they ask patients to come back and why
- Coordinate visits between primary care doctors and specialists, and clarify each doctor's role for shared patients
- Offer alternative ways to connect, such as with secure messaging, telemonitoring or virtual visits, depending on the patient's case.
To learn more:
- read the commentary