Longitudinal care in the outpatient setting provides for appreciation of the natural history of an array of cardiovascular problems. It allows the fellow to become familiar with early manifestations and the evolution of cardiovascular diseases, the psychosocial impact of disease, and the effects and side effects of treatment. Longitudinal care also allows the fellow to meaningfully participate in preventive aspects of cardiovascular diseases, such as behavior modification. More important, it also allows for the establishment of a sustained, trusting relationship between patient and fellow.
We have an active outpatient facility at Lahey Clinic. The source of appointments varies and includes patients referred by primary care physicians from within or outside the institution, or from the section of surgery for preoperative consultation. It also includes patients who are self-referred for cardiac evaluation and patients who are seeking a second opinion with regard to a cardiac condition.
Each fellow is assigned to one half-day per week. Fellows are, on average, responsible for one to three new patients and one to three return visits during each-half day session. Patients who require continued care are followed by the same fellow throughout his or her three-year training period. Patients who may no longer require cardiology follow-up are referred back to their primary care physician.
The fellow is responsible for the evaluation and management of outpatients under the supervision of a faculty member who works with the fellow on a one-to-one basis. The fellow is also responsible for record keeping and correspondence with referring physician as needed on patients under the fellow's care.