Unfortunately, patients are often noncompliant with recommendations by pediatricians. Many parents fail to fill prescribed medications, and those that do often do not complete a full course of therapy. Patients frequently do not see consultants once referrals are made or make dental appointments for their children.
Let’s take a look at the many reasons for noncompliance among patients and parents, and detail solutions that will improve compliance rates for a wide variety of issues.
Routine care outside the medical home
One of the most egregious compliance failures is when patients don’t see their primary care physician for routine illnesses or well-child checks and choose instead to utilize urgent care clinics (UCCs).
There are many reasons for this. First and foremost, office visits can be expensive, and most parents have high-deductible insurance plans as a consequence of the Affordable Care Act. Parents save substantially by using the UCC down the street rather than making an appointment to be seen in your office. Many pediatric practices do not provide the extended evening and weekend hours that UCCs provide, and many practices do not facilitate access to care (see “Improve your practice: Facilitate patient access, Contemporary Pediatrics, January 2017).
In many pediatric practices, parents may be subjected to long waits on hold in order to speak with a secretary; convenient appointments often are not available; and patients are sometimes compelled to speak with a triage nurse even before an appointment is permitted to be scheduled. Additionally, if a family is enrolled in a large practice, they may not be able to see their own primary care provider due to availability of appointments.
As a consequence, the patient’s “medical home” is broken, care is fragmented, and unless practices take appropriate actions to remedy this situation, parents will continue to utilize UCCs. (See “Renovating your medical home,” Contemporary Pediatrics, July 2014).