Rewarding

I was glad to see that I’m not the only one obsessed with the frequency with which specialists recall patients for review. A recent US study in the Annals of Family Medicine looked at over a billion (!) specialist visits and concluded “The results of our study suggest now that not all activity performed by specialists when in a specialist role may require specialized care.” The study found a high percentage of internal demand/patient recall among US specialists.

Our recall numbers caused a little consternation in December. We’re still not sure what was going on in our clinic to give a spike in recall rates. But, we’re happy to see that they’re back down in early 2009.

There’s still a marked variation in recall rates among our group, so I think there’s still a lot of juice to be wrung out of aligning practices in this area. As our recall rates drop, we’ll open up more capacity to see new referrals.

Awkward

The problem with first-year medical students is that they haven’t yet learned which questions not to ask.

Two weeks ago, I had a student spending the afternoon with me at my office. We met a patient and his wife, and talked with them about the results of a CT scan he had done earlier in the day. After the visit, the student asked me "Why did he have to come to your office today?" Her concern was that the man had difficulty walking and had recently moved into a care home an hour away from Saskatoon. It was a significant effort for them to travel, both to get to Saskatoon and then within the city.

My staff is diligent about scheduling CT scans (and other tests) on the same day as an office visit, so I can review the results with the patient. I pointed out to my student that this saves people an extra trip into town.

Then she got really impudent.