What is a physician’s duty to follow-up with a patient?

The complication in the present case is that the authorities also recognize the fact that when a physician provides advice to a patient regarding follow-up care, it is generally the patient’s responsibility to ensure that he or she attends as necessary. This latter point was the issue in Wei Estate v. Dales, [1998] O.J. 1411. In that case the plaintiff suffered from a drug-resistant strain of tuberculosis and was taking powerful medication with serious potential side effects. The defendant counselled the plaintiff regarding medication, side effects, and the need for regular monthly check-ups. The plaintiff missed follow-up visits and eventually reacted to his medication, developed hepatoxicity and died. Although the trial judge found that the defendant did not have a follow-up system for patients who cancelled or missed appointments, and that such a system might have prevented that deceased from developing hepatoxicity, he went on to conclude, at para. 108: 108 The patient himself had a responsibility not only to take the medication as prescribed but to monitor his own signs and symptoms and to comply with the request for follow-up appointments. 109 The treating physician cannot be expected to follow-up every instruction given to a patient. The treating physician has the right to expect the patient will follow his or her instructions. If the patient disagrees with the doctor’s instructions, then he has a duty to advise the doctor.