Sunday, December 12, 2010

"Lost to follow-up"

This phrase is one that is often used in scientific literature to describe members of a longitudinal experiment who cannot be contacted after a certain period of time following the initiation of the research project.  They have been lost as far as the researchers are concerned.

I have titled this post as such because this phrase keeps running through my mind as I consider some of the patients I have seen and treated in the ER.  A vast majority have been treated and discharged, some have been treated and admitted only to be discharged a day or two later by their hospitalists.  I don't consider these patients "lost to follow-up" because there is, essentially, no follow-up required.  We have provided definitive care either in our ER or within our hospital system and these patients leave my care in stable condition.  However, I carry the cases of a select few patients who did not receive definitive care while I was rotating through the ER.  Over my month-long clerkship, there were just a few patients who were so ill as to warrant admission, but who did not receive a cure while within our system.  These few are lost to follow-up for me, and it occurs to me that I am somewhat saddened by the fact that I couldn't have a hand in "fixing" them - making them free of their illness as I was able to with so many others.

This is part of being a student - involved in a certain population for a while, then off to the next rotation and everyone you had previously cared for is lost to follow-up.  

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