Should We Discharge Patients from Care?

A patient comes to the clinic to seek care for their injuries, pain or other problems for the first time. They start by signing in with the reception desk and wait to be taken in for the appointment. Once the patient is in the treatment or consult room with their healthcare provider, the typical course of care begins:



This standard practice includes several follow-up visits where the patient will continue to be evaluated. Eventually, the patient is discharged from care, either because they've met their goals, they can continue a self-managed program or be referred to another provider to continue their treatment. However, it begs the question - why do we discharge patients? Why is there a start and an end to treatment?

Patient care is continuous. Receiving care doesn't necessarily have to be an in-person doctor's visit or an appointment. Knowing that a healthcare professional is managing and monitoring a patient's care can be a sense of security even if the patient is not physically present.

Does this mean that the above structure should be changed? Perhaps each visit with a patient and healthcare professional should be seen as an episode of care and therefore is just one point in the continuum of care. For some, seeing a provider once a year may be sufficient. In contrast, many years may elapse for other patients before they require an appointment or treatment. Even though the time that has elapsed is different, the continuous loop of care does not change.

Perhaps the course of care structure should look more like this:

If patient care is thought of too linearly in the clinic, the long-term patient care and guidance they require may not be considered. By keeping the lines of care open for patients, they have the opportunity to learn how to manage their relevant episodes of care. Managing a person's health should be an ongoing process.