I think it is commendable that you are concerned enough to take on this much responsibility. I am sure other specialists can give you more helpful information, but bottom line, patients are responsible for their own care. If you give lab slips, you can set a reminder so you can reconcile, but other than that, you can't hold their hand. If they cancel or reschedule, you know then what is going on. If they no show, you can simply try to mail them or call them.
We get letters all the time from a neurologist to a patient which is copied to us saying they have not been able to reach them. Now, it falls on the patient and us. Invariably, we call the same number and reach them the first time. But, we also may have an updated phone number. Many patients change their number, and the last person they think about is their neurologist where they have an appointment in four months. Then you can't reach them for a reminder call, and they no show. I guess one breakdown in communication would be PCPs forwarding new phone numbers and addresses to the consultants.
I am always surprised to read in the letter where it says, we have tried to notify you four times but have been unable to reach you. And, then to the provider, "Please reschedule them if they still need us." That is more than I would do.
As far as meds go, it would seem they would call you for those. Again, a reminder would help as would a refill request from the pharmacy.
Better communication all the way around would be helpful. We forwarded labs to a consultant for over a year before she told us she was getting them. But, it is still difficult when a Dilantin level of 40 comes back. Do we just assume the consultant sees it? I would hope not, and we would call.
But, again, I don't lose any sleep over patients who don't accept responsibility for their own care. Most of my patients don't pay for their care, so they could at least make note of appointments in their calendars.
