事件记录
So you went to the doctor for a problem, 医生制定了一个计划, and you may have followed the plan or maybe you didn't, but you never told the doctor that it didn't get better. This is why follow-up is so important.
So it turns out that often people come to their physician, 在这种情况下, 对我来说, 是妇科医生, 他们有一个问题. 大发娱乐就说潮热吧. 他们进来了, 她们有潮热, 我谈论潮热, 我说, "I think you're a good candidate for some estrogen." And I write them a prescription, and I send them home. And I think I'm the best, smartest doctor that ever was because I didn't see them again. 现在，可能发生了什么?
统计, 50%的病人, they get a prescription for hormones, and this is just this particular kind of problem, but get a prescription for hormones, 永远不要填满它. 我知道吗？? 不，我不知道. My system doesn't tell me with a little alert on their electronic health record that she didn't ever fill it. So I don't know she didn't fill it. What happened if she filled it and took it and it didn't help, but she thinks I'm a bad doctor because I gave her something and she didn't come back? I have lots of other tools in my toolkit, but if I don't know from her that she isn't better, 那我就什么都做不了了.
So follow-up is a difficult thing, because it has to do with failure. It has to do with communication. So in the case of the thing that I know best, 也就是潮热, I may have not really gotten to the bottom of what this patient's primary concern is. Maybe her primary concern is that she's not a woman anymore, or maybe her primary concern is that these hot flashes make her cranky and she's angry at her family, and this is really not about hot flashes, but that's what brought her in. 我听到潮热. She's a woman of the right age. I prescribed a medication that usually works, and I sent her home happily according to me, 但她并不开心. And this is where follow-up is important.
Now, the question is, whose responsibility is it to follow up? I personally think it's my electronic health record, because the electronic health record should give me a ping if my patient didn't follow up the prescription. I think my electronic health record should send out a little reminder to my patient, "Dr. Jones gave you a prescription three days ago for the problem that you saw her for. 你好些了吗？? If you got better, keep taking it. If you didn't get better, please call. If you got better but you're having side effects, make a follow-up appointment so we can talk about alternatives." This is something that would be so easy for an electronic health record to do, and we get all these telephone calls anyway about what we thought about our doctor and what we thought about the clinic. So why not have a little reminder, "Your doctor gave you a prescription. 你填满了吗？? If you filled it and it didn't work, push 1. If you filled it and it did work, push 2. If you filled it and you had side effects, push 3, which it will get you right to my nurse."
So if your electronic health record doesn't do this, 而绝大多数人都没有, what should you do if it doesn't work? 你应该让大发娱乐知道. So if you didn't fill it but you're still symptomatic because you had questions that weren't answered, 打电话给我的护士, ask those questions on our private email, 或者回来找我. If you took it and did fill it and it worked, well, just keep taking it, and I'll see you in a year. If you took it and you had a side effect, 我想听听这个, because it turns out I have a whole bunch of other things in my tool case that we could try.
So I used the paradigm for hot flashes. I could have used it for any one of a number of common problems. But follow-up is important on my part, and follow-up is important on your part. And don't just give up because you tried once, because we have a lot of Plan B's. So keep thinking about it, learn more, come back and see me, and thanks for joining us on 范围.