Years ago, a new patient came in for a comprehensive eye health exam. The patient had long-standing glaucoma, with vision loss in one eye and the other close to it. I asked him when he received his diagnosis and whether he was taking any IOP-lowering drops for it. He responded that he was diagnosed more than 10 years ago, was told he should be on medication for it, but hadn’t seen that doctor, or any other doctor, since. I educated the patient on his condition, started him on drops and got him an appointment with a doctor who specialized in advanced glaucoma.

A few months later, I received a request for the patient’s records from his attorney. The reason: The patient was suing the eye doctor he saw 10 years earlier for malpractice for failing to treat the glaucoma. I don’t know how that case turned out, but it worried me that I could be sued for a patient not complying with my advice.

Here’s the thing: Doctors do get sued for loss to follow-up. That said, with protective processes in place, the likelihood of a successful lawsuit is small.

1 EDUCATE AND DOCUMENT

First, O.D.s should educate each and every patient on the diagnosis, any drugs needed for it and the risk to the patient for not following-up, as prescribed.

Next, the O.D. should document that she has provided this education, including the risk of non-compliance, and have the patient sign the document in acknowledgement. Then, the document should be scanned into the patient’s chart.

2 KEEP TABS ON REFERRALS

If the optometrist is sending the patient for a referral, he should document the time and date of the appointment and have the patient sign the document in acknowledgement. Then, it should be scanned into the patient’s chart, and she should be given a copy.

I recommend keeping a list of referrals and tasking a staff member with following up with the referral doctor to obtain a record of the appointment. If the patient did not show for the referral, this staff member would then call the patient and document the one, or more, calls. If the patient cannot be reached (typically after three unanswered calls), a certified letter should be sent to the patient regarding the need for the referral.

3 TRACK OFFICE APPOINTMENTS

I recommend having a designated staff member keep a log of no-show dates and corresponding phone call attempts to reschedule the patient. If all attempts are unsuccessful, a certified letter should be sent to the patient explaining the seriousness of the diagnosis and need to follow-up.

FINAL ADVICE

As with most issues in the optometric practice, it’s a good idea to have processes in place that everyone knows, understands and follows! Having such processes should be aimed at protecting patients and the practice. OM

DR. GILBERT-SPEAR is the founder and director of The Visual Performance Center and is a consultant and speaker with various eye care companies. She is a Florida-barred attorney, with a concentration in Health Law and Compliance.