Tuesday, August 25, 2009

August 25, 2009 - Be Your Own Advocate

Here’s a rather shocking statistic from a recent study: 25% of abnormal medical test results never get reported to the patient.

Part of this is due to the negligence of certain doctors and their staffs – although, in some cases, it has to do with the national shortage of primary-care physicians. Often, it’s the primary-care physician who wrangles the test results and reports them to the patient. If someone’s getting their basic care from a doc-in-the-box or an emergency room, the lab or specialist may not have a clear idea of the chain of command. (In case you don’t know, a “doc-in-the-box” is a nickname for a walk-in clinic, at least here in New Jersey.)

Whatever the reason, this number is way too high.

Actually, something like that happened to me with my colonoscopy several years ago (results were normal in that case). I didn’t hear from the gastroenterologist, and I simply told myself, "I guess no news is good news." On a subsequent visit to Dr. Cheli (my primary-care doc) a few months later, I asked him if he’d heard the results of my 50th-birthday colonoscopy. He hadn’t, and had one of his nurses call back, then and there, to the office of the gastro guy. Then, I overheard him talking on the phone to one of that doctor’s office staff, chewing them out for not sending the results to either of us. Good thing there was no abnormality – although his office evidently didn’t have a fail-safe procedure in place for checking back in the event of results that never came.

All of this just goes to show us patient types: in this crazy, dysfunctional medical system, we’ve got to be our own advocates. If we don’t look out for our own interests, it’s very possible no one else will.

A word to the wise...

So, what about the rest of you? Have any of you had difficulties with test results not getting reported to either you or your primary-care doc? Sound off in a comment, below...


Wendy S. Harpham, MD said...

Dear Pastor,
In my practice (before I retired due to illness), I had a series of checks-and-balances to ensure that correct results were reported to every patient. And the last fail-safe check was to put the responsiblity on the patient: "If you don't hear from us, please call us!"

I agree that patients should not assume that "no news" is "good news." No news is no news.

And if patients worry about being tagged a "difficult patient," they can just preface their request for results, "I don't want to be a bother, but I've been told to ask for my test results." And, of course, they can thank the person who got them the results.

Thanks for highlighting this important -- and easily fixable -- problem in patient care.

With hope, Wendy

Anonymous said...

Not only is that a problem but the patient is responsible for making follow-up appointments at an appropriate time as the doctor may have told them. It is easy to forget...

Yes, it is a mess and all indications are that so much misinformation is out there, that health care reform is a long way off!


Julie Orvis Marcinkiewicz said...

This makes me think of the what I understand is the French system of medical information. Everyone has a card the get swiped into central system of records and in this kind of information comes up because everytime you see a doctor your information is enter automatically because of the swiping system. It seems in the case that when you do have test, like colonscopy, you always have a follow up after to get the results.

I hope that we can end up with a system like that - seems like it make sure everyone has all their information and would save time and money, and lives.

But I worry that people would think of this as big brother ploy and it would never get through here in the U.S.

Unknown said...

I remember when I got a mole biopsied for melanoma, I was told, "No news is good news," by the doctor and that I would only hear back from him if the news was bad. The next thing I know, I get an automated message on my answering machine: You have an appointment with ___ Dermatology on ___ date at ___ time. I go in sure I'm going to hear bad news. When I get in, they say, "Why are you here? We haven't even gotten the results yet." I thought, all that anxiety for nothing. Well, the next day I get a call from a human being that, yes, indeed the mole was melanoma. If I'm going to get bad news, I want to hear it from a human being.

Carl said...


This story absolutely takes the cake. Telling patients of malignancy via robodialer - it's insane! Sometimes humanity just has to trump efficiency - although not in your doctor's office, it would seem.