You know those people who somehow get all of their follow-up testing and never miss a doctor’s appointment? They always know when they’re supposed to be back at the cardiologist’s office for a check-up, but they’re not supernatural. They’ve just figured out how to navigate this complicated process better than others. The rest of us are left trying to figure out how to survive the excess communication necessary to make sure every little thing gets scheduled in an era where healthcare is more decentralized than ever before.
Why Follow-Up Care Falls Through the Cracks
Missing follow-up care sounds like an inconvenience, but something that should never happen. A specialist recommends that you follow up in three months, but doesn’t book you an additional appointment. You visit your primary care physician, who orders bloodwork but never gives a call to say what your results are; you visit a dermatologist for your suspicious mole, but your family doctor never sends the recommendation along to the specialist’s scheduler. Three months turn into six and you forget what you were even supposed to be doing until it’s too late.
But it’s not an inconvenience; it’s a disaster. That three-month follow-up at the cardiologist was to assess whether your new medication was working – or quietly destroying your kidneys. Those blood tests that no one told you about revealed your thyroid was off. That appointment with the dermatologist was supposed to be about that weird mole because skin cancer is all about early detection.
What complicates this care is that it’s decentralized. If you’re working with five different doctors, that’s five different scheduling systems, five different follow-up requirements, five different interpretations about what’s communicated well enough to make the patient remember how and when to get tests done.
One office calls to check on you with follow-ups. The next requires a call back. The third sends a letter that could easily get lost in the mail while the fourth assumes that whatever was said in-office sticks with you, even if you’re stressed and focused more on getting back home than remembering when you’ll need to call them.
Everyone leaves a doctor’s appointment with verbal instruction and maybe some paperwork that says something along the lines of, “Come back in six months.” “Make sure to do those labs in three weeks.” “Let me know how your MRI went after you see the neurologist.” But life happens. You leave and have to check your emails, deal with work, get back into life, and before you know it, was it three months or six? Was it one week or three months?
What Actually Works for Staying On Track
The most organized people consider this a full-time job. They don’t employ systems of people reminding them what they’ll need; instead they presume that they’ve got it all under control.
Some have daily planners where things are entered. Others have spreadsheets dedicated solely to who they’ve worked with, when they’ve worked with them, what tests are ordered and when – and in this technological society, with apps designed for everything from transportation alternatives to weather notifications, you’d think there’d be an app for this; however, it’s hard enough to find one that actually works.
The bottom line is writing it down – immediately upon receipt of the information. Not later that day. Not when they get home. Right there in the doctor’s office or waiting area before leaving. What did they say? What’s next? When do they need to do it? Who needs to call who?
But there’s an added complication – staying organized will help only part of the problem. To book time for this means figuring out complicated scheduling systems, insurance checkpoints, and the overall complexity of getting something done – and this is where people’s systems fail. They know they need the follow-up. They’ve written it down. But calling someone feels like they’ll do it tomorrow – and tomorrow becomes next week.
It’s those who have missed follow-ups who’ve ended up in emergency rooms with complications or have gotten sicker than they needed to because no one caught something earlier that now prioritize follow-ups. It’s those who’ve become sick of stressing about whether they were supposed to do something until they realize they’ve totally forgotten.
When Professional Help Makes the Difference
Some people have realized that they need help from third parties and have started employing health advocates who basically act as dedicated coordinators for anyone needing this extra help; it’s not just for those who are severely ill; many people managing multiple chronic conditions or a myriad of specialists realize that paying someone to handle this is worth the money.
These people do it for you. They know your complete timeline and appreciate when everything’s due; they handle follow-throughs for scheduling; they make sure test results get directed where they need to go, and generally make sure nothing slips through the cracks as it could before.
For an individual with diabetes who’s also hypertensive and has arthritis with four different specialists, having one person who understands how it all interacts is far more beneficial than the average person who believes they’re going out their own problems one by one without realizing each condition requires care as well.
The Reminder System That Actually Works
Whether it’s their system or someone else’s helping them out, whatever works has multiple layers of protection upon it. Relying on one method means you’re looking at lost sticky notes or ignored phone notes down the road.
People who manage never missing their follow-ups use at least two or three devices against them. Yes, phone reminders on calendars. But also physical calendars that lay out whole months for easy use. Self-sent email reminders to calculate anything coming down weeks later since finding an appointment within weeks usually takes six or eight weeks anyway for initial consults.
Even some asking for family support in this matter is helpful – if your spouse knows you’ve meant to look into getting a colonoscopy two years after 50, you’re more likely to get when someone else gently reminds you.
The timeline matters too; if someone needs to call in three months time about something from today, it’s not just a reminder three months from now – but a reminder in two weeks from now about needing to call since finding a specialist will take time first.
What Happens When Systems Fail
Even with good systems in place sometimes things slip; offices forget referrals; schedulers lose information; authorizations drop in insurance; mail gets lost – you assume someone did something and realize it’s not been done.
And those who catch these issues right away are those who’ve proactively followed up – if someone says they sent a referral, you catch it in the specialist’s office in a week or so; if someone does bloodwork, you call them instead of assuming they’ll call you since that’s what they said they’d do.
You don’t wait around for systems – you verify where accountability lies.
This sounds exhausting because it kind of is – and that’s the real problem with health care – staying healthy as others makes you their accountability project, subproject, quality control department – and all that minutiae is exhausting enough as it is outside of dealing with having conditions at all.
Making It Sustainable Long-Term
The goal is finding something sustainable enough that one can maintain long-term – even if that means one tracking system taking up an hour each week isn’t going to last (it’s too tedious). If it’s too simple you won’t want to do anything when your motivated so finding something easy enough to do even when you’re tired or not feeling well.
For example, one central location must exist where all info goes – a notebook which travels everywhere every appointment, one app note on your phone, a specific folder in your email. The process doesn’t matter as much as building reliable access points whenever someone else needs information.
Then create opportunities to access regularly – Sunday night spend ten minutes assessing what’s happening in the week or month forthcoming and finding any tasks worth noting. Whether it’s the first of each month or every week, creating a proactive schedule helps avoid actively avoiding responsibility because people don’t want to do it.
The Real Cost of Missing Follow-Ups
It’s important to note what actually happens when follow-ups are missed – beyond health implications there’s a cost of missing them financially. Catching problems early is always cheaper than giving up – but assessments that seem unnecessary are way less expensive than hospitalization emergency rooms with an unmanaged condition.
The time cost is also horrible – dealing with a crisis takes so much longer than preventing routine care from unnecessary time added up – and stress of worrying about needing to not do something because you’re forgetting adds up over time.
The Bottom Line
Nobody should need a degree in healthcare administration just to make sure they get the follow up care their doctor says – but until systems manage better coordination patients are left filling that gap themselves – or finding people who will help do it for them.
People who never miss important follow-ups aren’t more organized – they’ve just realized healthcare is an initiative that must be undertaken and they’ve built proper systems accordingly (or found professional support) that ensure immediate retention by writing things down sooner than later along with multiple levels of reminders; those who follow up afterwards automatically – and don’t assume systems will work automatically without proper discernment get what they need every time without fail.
