Have you followed-up this patient?

This is a post by Dr. Anisha Sawkar. You can reach her here.

The question my residents dread:  “Have you followed up on that patient?”

I work in a teaching hospital and am one of the fortunate few who have residents do a lot of my work for me. Typically, as in a lot of teaching hospitals, the residents make the first draft of a report that is then checked by the consultant. This enables teaching and hopefully, the residents learn from the changes the consultants make and the subsequent interaction that helps them separate right or wrong.

This learning will obviously be helpful but does not compare with the kind of permanent learning that will result when they follow up the patient and confirm the diagnosis that was given. Residents need to remember that we are not infallible and what we said cannot be the gospel truth. The ultimate learning will only come with the “follow-up”. The habit of following up on patients needs to be inculcated in residents during their formative years and this habit will only be practiced if they see their seniors do the same. The example will only be set if they observe that at least in difficult or ambiguous cases, their consultants go out of their way to contact the referring physician/surgeon just to find out how the patient is doing.

In a busy chaotic 2000 plus bed teaching hospital and tertiary health care center, obtaining a follow up on a patient is not always easy, and therein lies the other aspect of the story. If we maintain a close working relationship with our referring colleagues, not only will our follow-ups become easier and forthcoming; the gratification of having made a difference or the humbling occurrence of having made a mistake will help us become better at what we do. And God knows, we need to be reminded of our limitations and learn from our mistakes. As Mahatma Gandhi beautifully said “It is unwise to be too sure of one’s own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err.”

At the resident level, these close interpersonal ties with residents of other faculties will enable a much smoother working relationship that will be of enormous help on busy on-call nights…these harmonious working relationship will ultimately benefit the patient.  Not to mention the fact that they will learn from their mistakes on call and hopefully from ours too. I’d like to end by quoting Brandon Mull who wisely said, “Smart people learn from their mistakes. But the real sharp ones learn from the mistakes of others.”

So, my dear residents, if you’re reading this, next time you’re asked for a follow up, please don’t silently curse your senior.  It is, after all, one of the best ways you’re going to learn.

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