Follow Up

To my ER friends past and present who also spent countless hours reading textbooks by Tintinalli and Rosen among others, can you recall any emphasis on calling patients for follow up? Personally, I can’t. These books have shaped our profession, but I think they share a gap. Maybe I need to reread them.

Regularly we in ERs write or type “follow up with your doctor or return to ER if worse.” Some prefab discharge forms have that already stamped. But in this day and age when patients either don’t have PCPs, or when they have to wait weeks for appointments, frankly, it’s just CYA.

With Pre-R we try to call or text every patient to be sure they’re improving. I’ve had more follow up this way in three years than I have for my ER patients in 20. It’s comforting when things go well, but super educational and even more important when they don’t. This practice has drastically changed my antibiotic choices, durations of treatments, my laceration and abscess aftercare recommendations and more.

I’ve learned about medication side effects and resistance patterns too. And I’ve learned about the massive hurdles patients go through to see specialists. I still make mistakes but this practice is certainly making me a better doc.

For $1000+ per ER visit I think standard of care should include a call or attempted call to literally every patient no? Could be a doc, nurse, tech, administrator, or med student placing the calls, no matter. I just want to know what truly works and what doesn’t. And to me, patient satisfaction surveys just don’t.

I remember writing “f/u w/ pmd” during residency back in the day over and over again. Totally absurd.

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