Physicians, medical offices, and other medical professionals and settings have a responsibility to do more than simply care for a patient once. They have a responsibility to follow up and provide after care. When this doesn’t happen, or there are failures in the follow up leading to inadequate care, the patient may suffer a range of consequences from mild ongoing symptoms to progression of disease and death.
Medical professionals are expected to take all reasonable steps to follow up with patients, even when those patients miss appointments or ignore medical advice. If they do not, they may be found to be negligent and a patient may be able to prove that medical malpractice occurred. Malpractice requires proving that a breach in duty occurred in the form of a failure to follow up and that it caused significant patient harm.
What Is Failure to Follow Up?
Part of the standard of care that physicians and other medical professionals is expected to provide is ongoing care. To simply see a patient once and not have a follow up appointment is not acceptable for most medical situations. A medical professional or a team have a responsibility to see the patient again, and to provide ongoing care, advice, treatment planning, and other elements of good care.
When a doctor does not follow up with a patient, even if the patient is the one to miss an appointment, it may be considered failure to follow up. This can be considered negligent behavior, and in fact is one of the riskiest problems in healthcare for the medical professional. Without good follow up a patient’s condition could get worse, there could be a delay in diagnosis, and may even result in death.
How Failure to Follow Up May Occur
There are many examples that constitute a failure to follow up, whether they are proven to be medical malpractice or not. From communication issues to failure to comply on the part of the patient, or even complete failure to contact a patient on the part of the doctor, there are many ways in which after care can be delayed or incomplete:
- Noncompliance by the patient with follow up calls, appointments, and treatments
- Communication breakdowns between patient and doctor or medical office
- Failure to contact patients after a missed appointment
- Failure to track follow up needs, resulting in incomplete after care
- Errors or incompleteness in medical records that lead to poor after care
- Failure to send referrals or order lab tests in a timely manner or at all
- Not following up with patient regarding the results of lab tests
- Not documenting patient comments and notes
- Failure to follow up with a patient after sending them to a hospital
- Failure to follow up with a new medication or new dosage
- Not communicating the urgency of tests, medications, treatments, or other medical advice
When Failure to Follow Up is Negligent
There are situations in which a failure to follow up with a patient is not the fault of the doctor. The patient has a role to play in this too and a responsibility to make appointments and take a physician’s advice. When a patient does not show up or does not follow through with treatments or instructions, and the doctor takes several additional steps to encourage the patient to do so, the failure may not be negligent.
However, there are also many situations in which failure to follow up is considered malpractice. Proving malpractice means proving that a duty to provide care was breached and caused the patient damage. Inadequate follow up measures not only apply, but are increasingly common as reasons that patients file lawsuits. As care has become more ambulatory, follow up care has become more complicated, difficult, an often inadequate.
Failure to follow up may be negligent when the medical office is not proactive about scheduling, making referrals, and scheduling lab tests. Office staff may fail to communicate test results, call patients, or send letters to patients who can’t be reached, and may not keep adequate records or tracking of patient follow up, all of which may lead to negligence. When doctors don’t communicate follow up care and instructions, fail to record patient notes and comments, and don’t manage medication or treatment instructions adequately, it may lead to proof of negligence.
Consequences of Failing to Follow Up
Good after care is essential for adequate treatment, and while in some cases failure to follow up may lead to minimal or no consequences, in a lot of cases the results can be seriously damaging to the patient. Poor follow up care, for instance, could lead to a delayed diagnosis or a condition that gets worse. In either case the resulting harm may range from additional or worse mild symptoms to severe symptoms and progression of disease, and even death. This can be especially serious when the patient’s condition is cancer. Not getting adequate follow up care often means not getting needed or recommended treatments.
The ultimate consequences of all of the possible ways in which after care can fail or be inadequate varies by individual. Poor follow up care may lead to suffering from symptoms that could be avoided, chronic pain, worsening and progressing conditions, emotional suffering, disability that may be temporary or permanent, injuries, additional illnesses, a need for more invasive treatments, extra medical bills, inability to work, lost wages, and in extreme but not uncommon cases the death of the patient.
Examples of Failure to Follow Up Malpractice Cases
Failing to provide adequate after care is a common claim made against physicians, and one that often leads to settlement for the plaintiff. In one case a woman who was in the hospital for congestive heart failure had X-rays taken during her stay. A radiologist identified a mass in her lung and recommended that she have follow up scans. The recommendation was sent to her physician, who did not follow up and did not tell the woman about the recommendation. She had a scan almost two years later and was diagnosed with stage III terminal cancer. She won a $500,000 settlement for failure to follow up.
Cancer is often the most serious consequence of medical negligence because any delay in diagnosis and treatment can lead to progression to a terminal illness. This was the case when a man was treated for a case of anemia. The cause of the anemia could not be found and eventually the man died of colon cancer. His family won a $596,000 jury award when they went to trial alleging that the doctor failed to follow up on the anemia, and that if he had the diagnosis of colon cancer would have been made sooner.
After care and follow up after examinations and treatments is a necessary part of medical care and an expected responsibility of physicians, hospitals, and other caregivers and medical facilities. There is a duty of care that extends beyond the initial appointment or treatment, and when this is breached it can cause significant damages for the patient and family. In many of these cases the patient or the surviving family may choose to file a medical malpractice lawsuit. If you find yourself in a similar situation, consider consulting with a malpractice lawyer who can give you the best advice and guidance.