In October 2006, I began my career as an independent consultant in surgical oncology at a busy university hospital.
One of my earliest patients was 59-year-old Raghavan (name changed), who successfully underwent surgery and adjuvant treatment for rectal cancer. After treatment, he underwent regular check-ups for five years as advised. In mid-2011, I told him that his follow-up period was complete – he did not need to consult me again unless he had symptoms, and only required a colonoscopy once every 5 years.
Six months later, he visited me in my out-patient clinic. He spent some time talking about his day-to-day activities and about his children. He was in perfect health. Thinking that maybe he didn’t understand last time, I told him again that no routine follow-up visits were required – and expected him to be relieved at not having to visit his oncologist again.
A few months later, he dropped into my clinic again, just to chit-chat for a few minutes. It was quite clear that that the reason for his visit was not medical – it was just to stay in contact.
Over the years, I have realised that quite a few patients like Raghavan choose to come in for consultations every now and then – despite my reassuring them that they are doing well and don’t require any more follow-up.
Initially, I used to wonder if my communication was not effective enough or if something else bothered my patients. What made them come back when there was no reason to?
With experience, I realized that this phenomenon is part of human nature. While many patients are happy to be done with their follow-up and prefer not to come to the hospital a single day more than required, some prefer to remain in touch.
I have often thought about the reasons for this. For someone, visiting may be a way of showing gratitude or goodwill. Maybe someone else comes to get comfort and reassurance. For another, it may simply be a way to keep a relationship alive – after all, they have gone through a long and sometimes difficult journey with us.
Today, I respect the fact that a patient may choose to come back even when no medical follow-up is required. I honor the partnership we shared in their moments of crisis and feel grateful I could play a role in helping them restore their health. For patients who choose to stay in touch, I do remind them gently that a follow-up is no longer required, but also convey that they are welcome to visit nonetheless!
Medicine is so much more than just treating an illness. It also includes elements of love, compassion, struggle, despair, triumph, and humanity. Accepting all aspects of human nature is a choice every doctor can make.