Follow Up Visits

[CuriousConundrum]

Hello, I work in mental health and have with the entirety of my nursing experience.  It's sort of the unspoken standard of care for most patients to return to clinic within three months for medication management.  Looking back over the last decade, I estimate about 40% of my patients have never needed quarterly follow ups.  For those, I may do 4, 6, or 12 months depending on what they're taking and their status.  

Admittedly, for the other 60% I get really frustrated with seeing them with whatever new crisis -real or imagined- they happen to be going through and some desire to "change meds" again.  I feel like we're playing Cups and switching around things with titrations, augmentations, substitutions, etc.  

Some of my patients see a therapist.  Some don't.  Most therapists aren't providing evidence-based psychotherapy so I don't see considerable improvement among my population for those that are "in therapy."  

Thoughts and opinions are welcome.  Most of my peers seem too enmeshed with patients to consider this objectively.  

[Tegridy]

I’ve found a lot of psych patients have unrealistic expectations part of which may be our fault. The other part may be just the way many of them are. This is in general medicine though most of our patients also have substantial psych issues also. Expectation setting is the best advice I can offer though I am sure most people do this and many patient likely selectively forget what we discuss with them.