Missed appointments aren’t just missed appointments: They’re missed opportunities for early detection

 

By Tré LaRosa
NeuLine Health

“I can’t miss work and stay home for 4 days.”

“I don’t have time for this test.” 

“I didn’t know the test was ordered.”

All of the above are examples of understandable and common reasons for why patients need to cancel or reschedule their appointments. Doctor’s appointments and medical procedures — invasive or not — are not walks in the park; often these are major stressors for us. Procedures and appointments aren’t the only part of the process that’s stressful: scheduling medical appointments can be tedious; coordinating accommodations for time off from work or for childcare can cost us money or force us to choose between work or health; we can be scared that the procedure may be painful or inform us of frightening health news. These issues together result in cancelled or missed appointments, and every cancelled appointment is a missed opportunity to detect neurological disorders early on before they become more severe.

Missed appointments are not uncommon; Kaiser Health News reported in the early months of the COVID-19 pandemic, 31% of all Americans reported delaying healthcare. Another study suggested around 40% of Americans had skipped a recommended medical test or treatment, and around 44% said they had refused to go to the doctor when they were sick or injured out of concern for cost. “Cost” is not a single entity like the expected cost for a procedure but many financial factors rolled into one; some people may not have ability to take time off work without losing income so attending an appointment could be a compound cost: the cost of a procedure plus the cost of lost wages for the time the procedure or appointment may take. Even considering the cost of a procedure isn’t always an easy task: nearly half of all Americans report being fearful of unexpected medical bills. 

For some conditions, missed appointments can prove to be a long-term mistake for a patient. The importance of early detection can’t be overstated: about 1 in 3 people in the entire global population are affected by mental or neurological conditions. Early detection could be the difference between managing a neurological condition and not. EEGs can help detect a number of these conditions including Alzheimer’s, dementia, epilepsy, Parkinson’s, PTSD, and TBI. For many of these conditions, the sooner treatment begins, the better the prognosis for the patient.

A statement from the European Brain Council in their 2017 white paper “Early Intervention: Bridging the Early Diagnosis and Treatment Gap” distills the importance of early detection: “There is still no cure for most brain disorders; hence, it is necessary to focus on risk reduction, preclinical and early detection and diagnosis, and timely intervention. Primary and secondary prevention strategies remain essential (available diagnostic tools for neurological disorders and routine mental health screening).” The following paragraph further conveys the importance of early detection in helping encourage others to take their health seriously: “Early detection and intervention with the necessary psychosocial support is also crucial to reduce stigmatization and fear of disclosure.” Early detection may not only improve the prognosis of a patient’s physical health, but also their mental health.

In their white paper mentioned above, the European Brain Council adds examples of certain diseases where early detection may be even more consequential. 

  • Schizophrenia has a “high success rate … if early identification of patients at risk, early detection of psychotic symptoms, and early interventions at the prodromal phase are enabled.”
  • The management of Alzheimer’s disease will be impacted “in several dimensions” by “the availability of biological markers for early disease screening and diagnosis.”
  • As stroke and dementias are among the “leading causes of severe adult disability,” prevention and early detection are of the utmost importance in improving outcomes. Early use of interventions due to early detection have been highly successful in “reducing disability and mortality from ischemic stroke.”
  • The EBC reports “Up to 70% of people with epilepsy (emphasis added by author) could become seizure free with timely and appropriate” interventions. They continue: “There is a marked treatment gap with respect to delayed diagnosis and access to specialist services and appropriate treatment.”

There are perfectly reasonable explanations for why people are missing or canceling appointments, but these canceled appointments aren’t just missed appointments: they’re missed opportunities to detect conditions where there is an understanding that early detection can help patients maintain a higher quality of life for a longer period of time.

Resources:

     

     

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