Dr. Amy Nett: Great question. This is variable. If someone doesn’t contact us for a year, no problem, because it might be that they were actually doing better and just kind of want their maintenance checkup, or hey, this new issue cropped up, anything else we should test or
think about? So that’s no problem. I can think of about three different cases where this has come up. One was a patient who had worked with Chris a few years ago and then wanted to get in, and since my practice was a lot more open at the time, he question. I decided to just start over completely with me and do the initial consult, case review, and do the whole process over. That was his choice and his suggestion, and some people like it because in his case, he was like, “I have enough new symptoms. I just want a clean slate.” Sometimes if you feel a little bit uncomfortable with them just jumping back in with a follow-up, they understand the process if they’ve worked through it with you before, and they understand the value, so it’s often really easy just to work with them and say, “Hey, I think we’re going to get a lot more information if we just kind of start clean and get a new baseline.” If someone comes back, for example, after two years, I haven’t seen them, and they have a new host of symptoms, then, yeah, it’s a great idea to just start over and get a new baseline because labs are so dynamic, and patients know that once they’ve worked with you.
Another case I had where that happened was a patient who sort of popped back on the radar after probably about two years. He just showed up for a follow-up on my schedule. Again, he had been working with Chris and then showed up on my schedule for a half-hour appointment, and this was a case where I said, “OK, well, what are your symptoms? What’s going on?” And it was like, “Yeah, I think you really do need a whole slew of tests,” so we kind of started over at baseline. Normally when patients are coming back, it’s because their symptoms have cropped up, and they generally want to do the whole slew of testing. Depending on how well I know what’s going on with their picture, I might not ask them to fill out the case review documents again, but I may just say something like, “Could you please schedule your next appointment for 45 minutes or 60 minutes to give us enough time to really go over all of the tests and talk about treatment?” I’ll just make sure that their second follow-up, when we do go over all the test results, is adequate in length, but it may not be the formal case review process.
We kind of take it on an individual case-by-case basis. It hasn’t been enough of an issue yet that we’ve made up any sort of formal policy around it. Hopefully that helps answer in terms of what we do for that.