Y'all are too nice. I just document that they were advised and either declined or failed to followup. Patients (and people) are free to make poor choices.
As far as MACRA changing the rules to sanction doctors with non-compliant patients, that may be a game-changer in the future. We may need to terminate these folks for our financial survival. I hope there is some exemption if the doctor made an effort but the patient balks.
