Doctors Not Advising Patients of Abnormal Test Results

A recent study in the June 22 issue of Archives of Internal Medicine has shown that patients who visit their primary care physician for routine screening and/or blood tests are most often not notified of the results, good or bad.

Surprisingly, this study noted that it was "relatively common", for medical staff to fail to follow up with their patients and to inform them of their test results.

Lead author of the study, Dr. Lawrence P. Casalino, who is also an Associate Professor and Chief of the Division of Outcomes and Effectiveness Research in the public health department at Weill Cornell Medical College in New York City, acknowledge that:

"If you're a patient, it's often assumed that no news is good news. But the bottom line is that is not always the case, and patients should not passively go along with that."

In order to conduct the study, the researchers assessed the medical records of 5,434 people who were aged between 50 and 69 years. Their focus was primarily on those patients who had had abnormal results on one of 11 blood tests or one of three screening tests at primary care facilities in the Midwest and on the West Coast, during the previous year. Next, they scanned through 176 surveys that were completed by physicians that were designed to assess test result management procedures at each of the facilities.

The study revealed that in 135 cases either the patient was either not informed of an abnormal test result or the facility did not document any communication with the patient about the results in their file.

In addition, the study proved that most of the primary care facilities did not even follow their own protocol for test processing, and most facilities did not even have a defined policy on how to communicate test results to their patients.

Whilst the research did not indicate any dissimilarity in test failure rates between facilities that relied on paper records and those that relied on electronic filings, facilities that actually used a record keeping method of both paper and electronic filings had the highest failure rates.

Obviously, medical facilities and practices that had a better test result communication protocol also had lower failure rates in the study.

"Yet even in the best doctor's office it is possible, and, actually, not uncommon, for test results one way or another to get overlooked. A good relationship with your doctor is a valuable thing to have, but in this case it isn't enough. You still need to be told whether your tests were normal or not. And if you don't get the result you're waiting for, you really should call the doctor's office and ask for it," Casalino said.

President of the, not for profit, National Patient Safety Foundation, Diane Pinakiewicz, explained that the results of the study demonstrated a perfect example of a patients safety concerns in "an imperfect system with any number of opportunities for things to go wrong or fall through the cracks."

"In the past, 10 or 15 years ago, if you didn't hear back about diagnostic test results, you probably simply assumed everything was OK. But the culture of medicine is changing. The patient of today is very different, and physicians and clinicians are also different. We know a lot more today about the safety importance of making sure physicians go through the entire continuum, from taking a sample to delivering results to patients. And physicians understand that transparency is important, and a patient's right to know is important," said Pinakiewicz.

Regardless, Pinakiewicz points out that keeping proactive vigilance over their medical records is extremely important for patients to do. Patients should routinely request copies of their medical records from both their primary care doctor and from any specialist or laboratory, especially if the patient is going to change health insurance carriers, or if they are going to relocate from a hospital stay to outpatient treatment instead. She explained that:

"Patients should not accept it when a physician or clinician says they will let you know if something is wrong. Patients should ask for their test results on a consistent basis, whether or not the results are of concern, because, if you ask for them 100 percent of the time, there is no question you will always stay informed."

Photo Credit: SarahMcD

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