Your doctor ran some tests. So…where are the results?

Unhappy Campers

My friend Rob was not a happy camper.

After his doctor ordered a routine blood test, she called a few days later to let him know that his cholesterol and triglyceride levels looked fine. Great news! Take care. See you in a few months for another check up.

But a few days later, Rob was in for a surprise…

Three degrees of disturbed

When Rob received his bill for the blood test, he thought it was abnormally high, so he took a closer look at exactly what had been tested. His doctor hadn’t mentioned that she was testing, among other things, his vitamin D level. And that test alone cost more than $200! (So is this the drawback of vitamin D’s current superstar status – diagnostic labs are gouging us to test it?)

When Rob called his doctor to find the outcome of his D test, he was in for another surprise: His D level was deficient, in spite of the fact that he supplements with D3 and cod liver oil, and tries to get a few minutes of daily sun exposure. (The test was taken in March, at the end of winter when D levels would naturally tend to be low.)

At that point, Rob wasn’t sure what disturbed him most: the exorbitant charge for the D test, the fact that he was deficient, or the fact that he might have never found out he was deficient if he hadn’t made a point to ask his doctor about it.

Rob relayed this saga when he called up to tell me he was sending along a Reuters Health article that describes an exact parallel to his experience. And it’s a good reminder: Don’t take anything for granted when interacting with your doctor.

Falling through the cracks

According to a new Weill Cornell Medical College study, a doctor’s time is largely taken up with examining and following up on laboratory and imaging tests. In fact, there are many steps in this process, and a breakdown at any point along the way might have dire results for a patient.

In their study, the WCMC team focused on just one of the steps: Informing patients of test results.

Researchers reviewed records for more than 5,400 patients over the age of 50 who were treated in a variety of community and academic practices. Nearly 1,890 abnormal results were recorded, but in more than 7 percent of these cases, patients were not informed of the results.

The data also showed that some offices consistently informed patients, while other offices performed poorly, with as many as 20 percent of patients not being informed of abnormal results. None of the offices had a uniform system for informing patients, and offices that mixed electronic record keeping with paper-based record keeping tended to fail most often.

So is your doctor’s office one of those offices that don’t inform two in every 10 patients of important results? There’s no way to know. That’s why we need to stay alert and always ask questions like my friend Rob now does. Because you can be sure he’ll never again assume that a routine test is actually routine.

Sources:
“Frequency of Failure to Inform Patients of Clinically Significant Outpatient Test Results” Archives of Internal Medicine, Vol. 169, No. 12, 6/22/09, archinte.ama-assn.org
“Patients May Not Get Word of Abnormal Test Results” Anne Harding, Reuters Health, 6/22/09, reutershealth.com