Scenario 1 of 4: Transfer Protocol

You are the primary care physician for 67-year-old Ms. Gonzales. When she presents to you with shortness of breath and swelling in her legs, you refer her to a cardiologist and tell her to follow up soon. You also order an echocardiogram. You plan to follow her progress as she is transferred from your care to the specialist.

You chose Option B. This is not the best choice.

Consequence:
She gets an appointment two days later. When she arrives for the appointment at the cardiologist's office, her records are not there. The patient is unable to recall what her PCP told her about her medications. The frustrated cardiologist duplicates the history and diagnostic assessment, including an echocardiogram.

Two weeks later, before the repeated tests are reviewed, Ms. Gonzales is admitted to the ICU with pulmonary edema.

What went wrong?
When follow-up patient care is deemed urgent, the physician should take extra measures.

	directing more attention and time for patient education about the seriousness of a recommended test, appointment, or trip to an urgent care facility;
	transferring key information to the next provider right away orally, followed by written records; and/or
	making an appointment for the patient before she leaves the office.

Did you know?
Courts have held physicians responsible for making "reasonable" efforts to ensure that patients receive needed follow-up care, and for transferring patient information between providers.