February 1, 2014 
I didn’t even think this was a big question until I read an article in the AJMC (American Journal of Managed Care). I just assumed that there were clear guidelines (evidence-based) that would say a diabetic should see a physician every X months, a hypertensive every Y months, etc. Of course, every patient is different and their situation unique, but I thought there would be a starting point.
According to the article and the meta-analysis they did, the evidence doesn’t exist. If that’s true (which I believe), then this could be a significant factor in overutilization.
According to the National Health Statistics Report for 2009, there were nearly 1 billion office visits in 2009, 30% of which were for routine follow-up of a chronic problem and an additional 26% of which were for preventive care or follow-up of an acute condition. The remaining 42% were for the evaluation of a new problem or an exacerbation of a chronic condition.
In their example, they model that moving hypertension follow-ups from 6 months to 9 months would save $1.5B a year in healthcare costs.
The same scientific rigor that guides therapeutic decision making should be used to optimize chronic disease management. Rational choice of follow-up intervals is a crucial step in adjusting current utilization patterns to maximize the quality of patient care while minimizing unnecessary costs.
Enabling Healthy Decisions 
In theory it sounds reasonable,but how do you educate hundreds of millions of American’s regarding any proposed protocol. Where would they go for informationresolution regarding the various symptoms they experience? The emergency room?
I don’t know if you specifically have to educate them, but I see several solutions here:
1. These guidelines can be embedded into the EMR tools that the physicians use so that the scheduling protocols at the end of a visit automatically set up the right follow-up.
2. The care gaps engines which exist can monitor claims data to identify the right time for follow-up and trigger an outreach to schedule an appointment.
3. Those using mobile apps and/or PHRs can be reminded as appropriate.
I think it’s less education and more about intelligent workflow.