If a patient is not improving, what action should you take?

• A. Continue current plan unchanged.
• B. Refer them.
• C. Discharge the patient.
• D. Increase frequency of visits without change.

Answer: (B)

When a patient isn’t improving, the priority is to reassess and involve another clinician who can provide a fuller evaluation. In direct access practice this means referring the patient for further medical or specialist input rather than pushing ahead with the same plan. Not improving can be due to an incorrect diagnosis, an intervention that doesn’t address the underlying issue, or the presence of red flags or comorbid conditions that require different management. Referring allows for a more comprehensive workup, potential imaging or labs, and a revised treatment approach that better fits the patient’s needs. Communicate clearly with the patient and coordinate with the provider you are referring to. Continuing the same plan, discharging, or only increasing visit frequency without changing the approach does not address the root problem and risks delaying appropriate care.