Archive for the ‘patient communication’ Category

Lab Tests-How How Do You Want To Be Told Your Results?

August 7, 2012

This blog is a modification of an article by my colleague, Dr. Kevin Pho, which appeared in the August 6 in USA Today.
A patient once blamed Dr. Pho for causing him considerable anxiety because he had to wait several weeks before receiving the results of a lab test, which he had ordered.
Many patients commonly have to wait days, if not weeks, before getting lab results from their doctor. The delay can affect patients’ health negatively.

For instance, one study looked at women who underwent a breast biopsy for possible cancer. It took one to six days for these patients to obtain their results. Those who had to wait longer than six days had abnormal biochemical stress levels, which can potentially affect their healing times from the biopsy.

The U.S. Department of Health and Human Services wants to change the lab results system. HHS proposals would allow patients to immediately review their lab results via a website, almost at the same time as their physicians. Whether this is a good idea or bad will depend on what happens after the patients view their results.

What are the advantages of patients having immediate access to their test results? Most important of all the immediate access will reduce anxiety of waiting for the results. No longer will patients have to endure the antiquated retort from a doctor, “If you don’t hear from me, then everything is normal.” This wasn’t very acceptable years ago and is less acceptable today when patients have access to the same medical information that physicians have.

And the disadvantages?
Lab, pathology and x-ray reports without a medical professional explanation can be confusing and also be a source of anxiety. Raw numbers without the benefit of context can also make a patient upset and be a source of confusion. Some abnormal results are due to chance or lab errors. Other results can be a normal variation for that individual patient. Many lab results are misleading and not indicative of any disease. Patients often assume the worst, so viewing results alone might cause unnecessary alarm.

An unintended consequence of this approach could be that anxious patients flood doctors’ offices with telephone calls. Or they might go to the Internet for an explanation, which isn’t geared to a patient’s individual condition. A website could also provide the wrong information, which is sometimes based on opinion or a testimonial from another patient with a similar report but that doesn’t apply to the patient who is surfing the web.

I agree with Dr. Pho and that before performing any test, doctors should manage patient expectations. Doctors should tell patients what the tests results could indicate and how the results might affect their treatment. The conversation should end with a clear plan of how and when the patient will be informed of the test result.

So what would you like regarding receiving your lab results? I would like to hear from you and will try to adopt an approach that fits the needs and wants of my patients.