Vedat Verter
Professor & Stephen J.R. Smith Chair of Management Analytics
- Adapted from: “Impact of Psychiatric Follow-Up Frequency on Outcomes and Waiting Times ”
- Based on Research by: Martin Cousineau, Vedat Verter, Gustavo Turecki
- Journal: The American Journal of Managed Care (2024)
Key Takeaways
- Outpatient follow-up frequency in psychiatric care has not been well studied, but it has an important impact on access (i.e., the amount of time a patient waits to see a care provider).
- There appeared to be no practical difference in clinical outcomes of patients with major depressive disorder who had naturally occurring but different follow-up frequencies, but different frequencies had a significant impact on the volume of patients treated (i.e., the number of patients treated in a specified time window).
- Additional studies are needed for evidence-based guidelines to help clinicians make decisions about appointment frequency based on patient characteristics, and for investigating different aspects of follow-up outpatient visits.
Mental health is a critical element of overall well-being, and those struggling with this aspect of their lives may seek support from a psychiatrist. But how frequently should appointments be scheduled? A recent study by Vedat Verter and his colleagues examined how often patients with treatment-resistant major depression should see their psychiatrists and whether changing appointment schedules affects their health or clinic wait times.
Researchers analyzed 340 patients randomly assigned to four psychiatrists who used different follow-up frequencies (averaging 47 to 87 days between visits). They found no meaningful differences in depression symptoms, quality of life, suicide risk, or medication side effects across groups, suggesting appointment frequency doesn’t significantly impact clinical outcomes—however, psychiatrists who saw patients more frequently created longer waitlists for new patients needing care.
The research used patient questionnaires (tracking depression severity and quality of life) and applied Little’s Law – a property from the field of operations management – to model how appointment frequency affects wait times. Patients were followed for up to four years, with all groups showing similar prescription patterns and baseline health metrics. The key tool was comparing actual clinical data to theoretical models of how changing appointment intervals might ease bottlenecks.
Reducing follow-up visits by 24% for the busiest psychiatrists could eliminate waitlists without harming patient outcomes, a finding that challenges the assumption that more frequent visits always correlates to better care, and highlights opportunities to improve access by optimizing schedules. The study’s findings suggest clinics could standardize follow-up intervals for stable patients while reserving frequent visits for high-risk cases, balancing individual needs with broader community access.