The Forgotten Art of Follow-Through

Neil Baum, MD

Neil Baum, MD, is Clinical Associate Professor of Urology, Tulane Medical School, New Orleans, LA, and author of Marketing Your Clinical Practice: Ethically, Effectively, and Economically, Jones Bartlett Publishers.


A nurse tells the patient she'll call him with the results of his lab work in 2 days. She never calls. A new patient calls and ask for information on the procedure or service offered by your practice. The promised information packet never comes. At a quarterly staff meeting, a colleague asks a physician for information on one of his or her patients. The requested information is never sent.

The concept of follow-through is simple, but is critical to a successful practice, especially in this era when patients can obtain information over the Internet, quickly change physicians, and have high expectations regarding the follow-through and follow-up from their physicians.

I am not sure if follow-through was better or worse in the past. It doesn't really matter, because it seems lacking in many service industries today. The mark of the professional in any field, including medicine, is that they always deliver what they promise. As professionals, doing what we promise—or not doing it—is a measure of our integrity and it has an impact on our reputation.

How can we increase our follow-through? To make room for the renal commitments in your life, learn not to let your interests distract you. Be clear about what you are committed to following through on.

Next, evaluate how reasonable your commitments are. Have you made too many? Are they realistic in terms of your time, financial and schedule resources? Trying to follow-through on too much results in accomplishing little.

I suggest keeping a daily reminder list where you can record the commitments you make. I have created a white wall in my office that is divided into thirds. The first third is for calls and actions that have to be done before I leave the office each afternoon. The center third is for action steps that need to be taken within 48 hours. The last third is for commitments and projects with deadlines that do not need to be accomplished in the short term. This inexpensive an easy solution has significantly improved my follow-up and follow through.

Bottom line: Our reputations are not as good as our words, but are actions are what we are judged by. Inconsistency between what we say and do is the difference between success and failure not only in our practice but our personal lives as well.