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Some physicians are inconsistent in notifying patients about
abnormal test results
A new study shows that over one-third (36 percent) of physicians
do not always notify patients of abnormal test results,
especially when the patient is expected back shortly for a
followup visit. Physicians commonly lack methods to ensure that
they receive the results of tests ordered for their patients,
depend on followup visits to communicate results to patients, and
don't document reporting test results to patients. This lack of
followup can have a negative effect on patient care and may
increase the risk of malpractice suits, conclude researchers
supported by the Agency for Health Care Policy and Research
(HS07516).
Bruce D. McCarthy, M.D., M.P.H., of Henry Ford Hospital, and his
colleagues surveyed 207 attending physicians and residents in
family practice and internal medicine at a large urban teaching
hospital and 21 suburban primary care practices in Southeastern
Michigan. Reasons cited by physicians for not reporting abnormal
results were that the results were trivial, the patient was
expected to return to the clinic soon, and in a few cases, the
patient could not be reached, they forgot, or did not have enough
time.
Only 28 percent of physicians always notified patients of normal
test results; the remaining 72 percent left patients to assume
that "no news is good news." However, abnormal test results may
never reach the physician or fall through the cracks if a system
is not in place to ensure that test results are received by the
doctor. Such mistakes leave the patient falsely reassured when
they do not hear from the doctor.
Only half (55 percent) of physicians always made an entry in the
record when they notified a patient about test results, 30
percent did so most of the time, 12 percent in some cases, and 3
percent of physicians never did. About 77 percent of physicians
had no reliable method to identify patients overdue for
recommended followup testing, such as Pap smears and mammograms.
There is disagreement about whether it is the physician's duty or
the patient's responsibility to ensure followup; to some extent,
this depends on the significance of the abnormalities found,
conclude the researchers.
For more information, see "Patient notification and follow-up of
abnormal test results," by Emily A. Boohaker, M.D., Richard E.
Ward, M.D., M.B.A., Jane E. Uman, M.P.H., and Dr. McCarthy, in
the February 12, 1996, Archives of Internal Medicine 156, pp. 327-331.
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