No News is No News

Pastor Carl Wilton recently blogged about test results that never get to the patient (and sometimes not even to the physician who ordered the test). It stirred memories of my medical practice.

I'd set up a series of safety checks to ensure that my wonderful staff and I were on top of all pending test results. We made check marks when the lab hit the office, second check marks when the lab was recorded on flow sheets, progress notes documenting our review of the test results with the patient, and so on. Charts were kept in a "pending" cabinet until every test was in and reported to the patient.

I'm telling you, it was a lot of work. And despite our best efforts, occasionally charts were refiled too early. But slipups were not major problems, because we had the ultimate safeguard: our patients.

At every "New Patient" visit and again at follow-up visits, patients were told that the responsiblity was theirs to let us know if they didn't get the results of all their tests. We gave them a time line of when to expect the results. It worked like a charm.

The first step to Helathy Survivorship is to obtain sound knowledge. And no news is just that: no news.

Comments

[Kate]

My GP has instituted a system where you can log in and receive your test results. He lets you know how long to expect until they are back as they vary of course and then you sign in and check them out. If there is anything that requires discussion or follow up the office gives you a call. So far, so good.

[Finn]

My internist's practice also has an online system where I can view test results, but I almost never use it. Only blood test results are posted on the site, not all of them are included, and they only appear after long delays. Imaging studies & other test results are never posted.

Fortunately, my internist is very good about mailing me test results (or calling if something needs follow-up), and I call her office if I haven't heard anything after 2 weeks. For routine tests (like DEXA scans), I schedule them ahead of time so we can discuss the results at my next appointment. Same with my CA125 blood tests: I have them done the Monday before seeing my gynecologic oncologist so we have the results during my appointment.

[Wendy S. Harpham, MD]

Always happy to hear of systems that are working well. And your comments attest to the fact that not everything in American medicine is broken.

The more we focus on what is right, the better chance we have of reforming healthcare in postive ways. With hope, Wendy

[Jeanne M Hannah]

I was amazed and impressed that my latest mammogram results arrived in my mailbox 2 days after the digital imaging! In the past I would have received them from my internist, but 7 to 10 days after the scan. I love this new system. I am not sure if they use the same system if the scan is abnormal.

[Wendy S. Harpham, MD]

Dear Jeanne,
My guess is that you would NOT be informed of an abnormal mammogram by mail. It wouldn't hurt to call the office and ask the staff the policy on abnormal test results.

If they only inform patients of normal results by mail, then 2 or more days after your mammogram, "no news" is no longer "no news."

I would like to think that since staff no longer call with normal results, they have that time to call right away those patients who need further workup.

BTW, glad to hear your annual exam was normal.

with hope, Wendy