Here's what we would do:
Give every patient a follow up visit before they leave the office. If they do not want one, say you are very busy and need to at least put them on the schedule. They can reschedule it later if they need to. (In our practice, they will at LEAST need a wellness visit in the future.)
Give them a lab order for their seizure med levels to be drawn before their next appointment. Put a copy of the order in the Reconcile Book.
Make sure staff goes through the reconcile book regularly. We call patients twice asking if they are going to get the lab done. If we can't reach them, we send a letter. These attempts are documented on the original order sheet in the Rec book, and by the letter it is removed and put onto the chart. I'm hoping this will take care of any liability, showing good faith that we tried to contact them about their test. If it is something serious, like following up on a malignant pathology report, I may send it certified.
