While the response from Alice Gosfield, JD, to the legal question “Do we have a legal obligation to ensure that our patients receive necessary follow-up care?” [Practice Pearls, April 2008] is legally correct, it is clinically inappropriate.

The answer given was essentially, “If you do a good job of telling your patients when to return and documenting appropriately, your legal obligation is fulfilled.”

The problem with the answer is that we are not supposed to be about fulfilling the strict minimum legal requirements; we are supposed to be about taking care of patients. The ethical obligation of an aspiring medical home is to reach out to patients who are due for follow-up and remind them. And if they miss a follow-up appointment, remind them again. This is an ethical duty we owe our patients that is beyond any legal obligation.