I’m curious about why physicians refuse to release test results until they can discuss them with patients. I have to confess, it irks me. I had a biopsy last week (cancer not suspected but potentially other serious issues). I was at the hospital for a treatment for something else and asked if the biopsy results were in. They were, but obviously the nursing staff could not release them. I stopped by the doctor’s office in the same building to request the results and was told that the physician would call me with results and that the office staff could not release them. I said I wanted to read the report and they said I’d be able to do so – after the physician discussed the results with me.
Of course the physician didn’t call me today. That’s fine. But I’m traveling tomorrow and will be without cell access and thus will have to wait til Monday to get my results.
This whole process seems paternalistic to me. Yes, I know I will not be able to interpret the results before speaking to the doctor. But the additional time spent reviewing the report would allow me time to formulate my questions at the time designated by the physician to discuss the report. I think if a patient shows up at a doctor’s office and wants copies of a portion of his/her medical records, it should be provided, even if the doctor has not yet had a chance to read the results and discuss them with the patient.
So, physicians, what is your office policy in these circumstances? Why not immediately release results when they are available? In these days of electronic records, I believe they should be released simultaneously to doctors and patients. This paternalism is irritating to no end!!
Not a physician but just wanted to share that the medical group I go to has an online system where results are released and you receive an email to let you know to log in to see your results. Now, I’m quite sure that the ordering physician sees the results first and has to release them but I’ve never waited long for results. Of course, I’ve never had a horrible diagnosis (not that I"m suggesting, @nottelling , that you have one) but it’s very possible doctors might make a call before releasing certain (negative) test results.
We can also email our doctors through this system so, if you have a question about your test result, you can email the doctor. The results also generally show whether the test result is in the normal range or shows something.
I’m sorry you have to wait and I agree that it seems paternalistic and, well, controlling. Very frustrating indeed!
Test results must be interpreted. There are false positives, false negatives, results that can be off and not mean much and results that can be in range that mean a lot. Imagine a patient not following up because a result is in “range” but the doctor knows that the result is problematic. Or the opposite, a result so out of range that the doctor interprets to be lab error (and retest) while the patient is sure they now have some incurable illness (and suffers needless anxiety waiting to discuss with the doctor). It is bad medicine to release data without the interpretation of the data. It also ensures that a conversation will take place. Not paternalistic; best practice.
Many patients (more than you might ever believe) are very time consuming to deal with and anxious about test results. Some don’t have the cognitive capacity to understand that a 2.49H is meaningless whereas 2.49H in another instance is an acute medical problem. Some want to discuss the 2.49 for 2.49 hours. Others want you to talk to their husband because he manages that. And don’t forget to explain it to my 9 children.
What about people who look at their lab results after work on Friday and want to discuss? Just call the guy who has been on call for 25 years and have a chat ad lib. How much are you willing to pay per minute to discuss the results with your physician? If the answer is commensurate with the physicians hourly income, then look all you want. Of course, the collective answer approximates zero.
Think of the workflow for physicians. A typical internist orders labs all day long and the tests done somewhat randomly on the calendar. Nowadays the results return electronically and at some point in the day the doctor must reconcile the tests and make a disposition with the results. If just 1% of people want to discuss the results before the doctor reviews them, then the result is a huge disruption in productivity. Imagine 1% of the 200 people on your next flight who want to chat for 10 minutes with the staff before you are allowed to board - and you get to pay for that time.
For better or worse, many electronic health records have portals on which patients can view the results of tests and communicate with the physician. In fact, this communication is an Obamacare mandate in which the physician is effectively fined if he does not participate sufficiently for arbitrary and ever changing government standards. So in the future, you will have a much better view of your results, can chat with your doctor online, but rarely see him. In my view, better to have a paternalistic doctor who cares about you than a paternalistic government.
I also think it’s paternalistic. One doesn’t have to be a rocket scientist to read a MRI or CT or lab report. To understand every nuance, yes. To read whether there are tumors, within normal limits, benign or cancerous, no. There will be some medical lingo, but the summary and findings are not that difficult to comprehend.
The amount of stress or anxiety waiting on test results can be through the roof, and yes, it does fry my cookies when I’m waiting 10 days for a dr. to release a result I know was there that afternoon. Then at the end of the process, a nurse on the phone says, “You’re results were ok.” More than once for my D, there were things that were high/out of whack, and when brought to dr’s attention, needed retested. Hmmm
Please don’t tell me to find a new doctor. There is a huge shortage in the specialties D & H need and we have had the above happen on multiple tests over the years, the most recent July of this year for a suspected brain tumor. 10 days to find out the CT was clear…not cool. Same on MRI.
many practices and hospitals have on line access (it is true they have a delay of several days or more so the doctor can review results with you first)
also quest diagnostics (super large company)which does blood work and pathology on things like pap smears has online access …which depending on your state has different delays on release time to you on line. (my friends gyno uses quest for pathology and she gets her detailed pap smear info and past tests on line) they also have green and red highlights on stuff and normal ranges for blood work and your history on a graph. https://myquest.questdiagnostics.com/web/home https://myquest.questdiagnostics.com/web/appts?action=PHRAd#
now her gyno also has online access to everything and you get an email when results are in so you can log in and see them as well as past history, mammograms, meds, make an appointment, request refills etc…
and the local hospital group when they do mammograms/breast ultra sound ,the radiologist reviews it with you waiting and comes out and talks to you and hands you a paper with his/her findings. no waiting for a call. really awesome if you think about it.
The results of blood tests and other automated lab results are posted on my health system’s portal as soon as they are available. I find it immensely helpful and has made me a much better health care consumer.
What is not routinely posted are results of biopsies, imaging tests like CT scans, pathology reports and things like that. Anything where there is a written narrative by some other physician (as opposed to automated results) are held until the ordering physician affirmatively releases them onto the portal. Those are the type of results I am talking about.
I don’t find your explanation persuasive. The physician should manage his or her time to deal with phone calls to discuss lab results. In fact, I believe they should routinely schedule appointments for follow up telephone calls. I absolutely believe they should be paid for those calls. The fact that some physicians have a hard time managing their schedules does not mean that I, the patient, should not receive the written results when they are available, or, more precisely, on demand. In fact, the withholding of results leads to more follow up phone calls and emails because I’m dependent on the physician to communicate them to me.
Releasing results does not mean the physician has to communicate with the patient on demand. When the patient requests results before the doctor has time to discuss them, his or her office staff should say, “We will provide the report with your results, but the doctor is not able to discuss the results until Tuesday at 1 pm. Does that work for you?”
@WISdad23, if you are a doctor, your distainful attitude toward your patients is coming through. I actively try to screen out doctors with attitudes like that from my medical teams.
So much needs to be explained when you are looking at a patho report or an imaging report.
For every 5 rational intelligent people who just want to look at the report and put together a list of questions, there are another 5 who would read the report, think they know it all and refuse to come in to the office for a sit down review of the results. They refuse to come in for an office visit because “ya’ll are just trying to get my money.” They want a 30 minute phone call consult for free. It’s just not always possible. I am a nurse practitioner and worked in family practice for five years. Our office was closed 1.5 hrs for lunch every day. Guess who never took a lunch? The MD I worked with and myself. We were chasing people down trying our best to make those important phone calls.
@nottelling …I agree. We should be paid for telephone calls.
Don’t even get me started on why physicians and PAs/NPs have a hard time managing their schedules. It should be so simple but it is not.
I always made a point to sit down and personally call patients with the basic results of their scans BUT there is usually too much to go into on the phone. For instance, a CT of the abdomen where you were specifically looking for say diverticulitis will also give a full report of the liver, lower lung lobes, etc. etc. Almost always the report will show some irregularities that would’ve likely never have been noticed but now since they are documented, must be reviewed and have some sort of follow-up plan noted. I always felt the scans were expensive and time consuming and whenever possible they warranted a courtesy call from me to at least say “hey your scan is negative BUT, please come in for an appointment because we have a lot to review.”
@nottelling telling I am a physician and I am not disdainful to my patients. I am one of those who still does call for indigent patients for 25 years in a row while many others don’t. But please feel free to screen me out.!
While you are concerned about shortages you also want doctors to schedule time to call every patient to discuss lab/test results? And you mention that doctors should manage time better? And you feel that doctors should be paid for phone time - well they are not and never will be in the current regime. The powers that be are very clever and have limitless resources at work to impede a doctor’s efficiency through mind-numbing regulation and policies.Every minute of billable time is considered a “cost center” to the payer sources.
If you work with doctors administratively and get on them for not keeping up with lab results they uniformly tell you that they are overwhelmed, that they don’t have sufficient support staff, that they are already spending too much time in useless regulatory activities and meetings, etc. None of them beg for even more uncompensated time on the schedule.
@WISdad23 exactly! Again… I’m not an MD but as an NP we work right along with the MDs. The burnout possibilities are very real.
@nottelling … The reason we can’t manage our schedules? Because patients don’t read our textbooks. They don’t always present with classic symptoms. They book an appointment for a “cough” but in reality it turns out to be a congestive heart failure and the 10 minute “cough” appointment required an EKG, a possible ER referral, a chest X-ray and more. Are we supposed to turn that patient away because he didn’t read the book and didn’t know that PND and orthopnea are not part of a routine cough presentation? Pretty sure if that was your dad or spouse you would want the right thing done for your family member. Doing the right thing requires time-- some of which is appropriately planned and some of which is impossible to plan.
Now the waiting room is backed up almost an hour and we spend the rest of the day apologizing. Most people are understanding— but there are always a few who are not.
And in between putting out those fires we are supposed to make those phone calls?Sometimes I can and sometimes I can’t.
Love my career and I love my patients. There is just soooo much more that goes into it than looking at the paper and saying “oh its negative.”
I’ve never had a doctor call with results, it is always a nurse. If I have a question it must be routed through the nurse to the doctor and the nurse will call with the answer.
We get better service from our veterinarian who will call immediately with any test results even if it his day off.
Whenever possible I always tried to give at least a call that to say “Good news! Your scan is negative! Bad news— still gotta figure out what’s going on and also review other parts of the scan. Let me transfer you to the front desk so you can schedule the appointment.”
Patients go through a lot of trouble and expense for these scans. I never made people wait over the weekend or overnight. All of them got a quick call from me personally. Sometimes it meant no lunch and not leaving the office til 6-7 pm. All of it not reimbursed by insurance. But all of it reimbursed by grateful patients for the most part.
For me, the fact that physicians often don’t have time to call to discuss test results for weeks is a reason TO provide the reports to patients when they are available. Then at least the patient has SOME information, instead of having NO information at all until the physician has a sufficient break in his or her schedule to allow for a call (often rushed) to convey results.
I’m not asking for a detailed phone consult on demand; I just want to see the damned report. Post the report when it is ready and then call me at your leisure. What’s so hard about that?
It would certainly be much more efficient than the current procedure where the actual report is not released until AFTER the physician goes over the results with the patient. In that instance, further follow-up calls are often necessary when the patient has questions about the report. That’s when doctors really get annoyed because they feel the critical info has already been conveyed. If the patient had been provided with the report in advance, the patient’s questions about the report could be addressed in the initial call to go over results.
More fundamentally, it is the patient’s information. If the patient wants to view the information, he or should be able to do so, even if the doctor would prefer to keep the info from the patient until it is more convenient for the doctor to release it.
Wisdad23 I agree that doctors should be paid for phone calls and I also agree Obama care is a Rube Goldberg Machine designed by politicians who are clueless and have forced many doctors into early retirement (and I know the current regime could care less) I also think patients should get rapid results by online portal or email.
even a quick email—like everything is good or we need to see you right away. and it does piss me off when I hear people say oh the doctors office just wants me to come in to milk my wallet/and at the same time I do not want to wait 2 weeks for results…I gladly pay and go in for results. along the same line the other day a lady in front of me at the pharmacy was pissed because her RX was $3.00…seriously? how much was your cup of Starbucks coffee you were holding? this is you medicine! I would hate to be her doctor.
Yesterday
My moms rheumatologist
“Your blood work looks fine”
We had reviewed on portal and asked
“What about calcium levels too high and the other titer out of normal range”
In two minutes she explained it all.
Had we waited received written report- we would have called back and needed explanation.
So sometimes best for patient to see, and get answers to questions. @nottelling please do come back and fill us in on drs explanation
@nottelling, how does your scenario in post #13 work with those who are less educated? Less literate? Mentally unstable? Smart as a whip but not familiar w/medical terms? The elderly who might become overwhelmed and assume the worst - or ignore the obvious? Making that professionally contrived information available to someone not medically trained without anyone on the medical side educating the patient from the get-go is not medically responsible.
You may be able to handle and interpret your info without problem. Many others cannot.
In the OP’s situation, wouldn’t it be better if there were some feedback (on the web portal or a note that the other staff can pass on) on whether the physician has reviewed the results? The OP only knows that the lab is done, but has no idea whether the physician has even reviewed them.
Of course, if the physician has reviewed the results and found nothing that could possibly be of concern, releasing the results with the physician’s message to that effect would make sense. It is understandable that, in a more complex type of situation, the physician may want to discuss the matter with the patient when giving the results.
I thought that medical records belong to the patient. On a heath board I participate in the understanding seems to be that if you show up and ask for the report they have to give it to you. Is that not true? I can have a test and the doctor can refuse to release the results to me? That doesn’t sound right, although I understand why a doctor would want to interpret the results for a patient, do they actually have the legal right to withhold the results?
nottelling I do agree it is your info and is yours to have! it is wrong you can not get your info until it fits into the doctors schedule and they are never available. just give the info via web portal on demand not delayed.
if all is good, and you see it 99.9% of people will not call the doctor . if it is bad you need to schedule an appointment or see a specialist if needed and you will know to do that.
sitting around waiting and wondering is horrible.