<p>I recently saw a specialist for what I completely expected to be a very uninteresting problem. The specialist decided there was a chance that this problem was not uninteresting and ordered some tests. Perhaps I have been spoiled by my GP, who has always provided test results over the phone, but when I called the specialist to find out about the test results, I was told that I would need to make an appointment to come into the office to find out the results.</p>
<p>I find this infuriating for several reasons. I feel like the doctor is holding the test results hostage, and I need to pay the office visit fee to get them. Plus the waste of time and energy for an appointment to find out that no, you don’t have the really bad thing that you might possibly have had. (Not that I am not happy that the results are good; just frustrated that I had to show up in the doctor’s office to find that out.)</p>
<p>What do you all think? Is it reasonable for a doctor to refuse to tell patients test results over the phone, and to insist on a office visit?</p>
<p>If you’re going back just for test results, unless he actually does something else during the visit, I think there’s a good chance you might not be charged for the visit. It’s almost like a continuation of the first visit, interrupted by the test that you couldn’t have then and there. However, if he does another exam, etc. to confirm what he now knows from the tests, then I’d expect a charge. And they can’t do an exam over the phone. </p>
<p>Of course, none of this may apply since you have not provided any details of what kind of exam was done the first time around or what the problem is.</p>
<p>It’s kind of like when I have to have blood drawn, but they want a fasting draw. Can’t do it the first time I’m in the office, so I have to go back. But I’m not charged for a visit (even a nurse visit) when I go back the next time, after I’ve fasted.</p>
<p>Depends on the test. One compromise would be to explore the option of reimbursement for time spent on the phone (I’ve heard of a few states piloting this for mental health consultations with primary care providers…) My lawyer sister might call it “intellectual property” and her phone calls cost by the minute.I could easily spend the whole day on the phone, with things I can’t get paid for.</p>
<p>I feel the same way. Last year I had a CT scan by a specialist and I was told I would have to come in for the results which bothered me. I never did and recently found out from my primary care doctor that the results were sent to him and they were normal. So you might want to see if your primary care doctor was sent a copy of the report and will give you the results.</p>
<p>I can see it if the issue is complicated and needs follow up treatment, or if even the normal results suggest some additional discussion and tests are needed. But would seem quite bizarre if you go there just to be told you are fine and can forget about it. </p>
<p>I quite like that all our results are available on line up here in the Canadian province in which we reside. Log on and within a day or so most of them are there for reading, along with the range. I and one of my kids needs a lot of frequent blood testing so it’s great for us. </p>
<p>Our doc will still call if results need responding to but being able to see the results so fast and read them ourselves is wonderful. I know Israel has something similar. I imagine most countries with centralized medical systems now make this available. Sure saves a lot of resources.</p>
<p>OP: Perhaps I’m not reading your post correctly, but I’m not clear on whether or not you’ve been to the follow-up appointment yet. </p>
<p>If test results are positive, I can see why a doctor wouldn’t want to discuss that over the phone. He/she would not only want to make sure the patient understands the diagnosis, but would also want to put it in context and begin discussing treatment. My SIL got the news about her breast cancer over the phone at 4:45 on a Friday afternoon, delivered by the doctor’s nurse. The only other information she got in that call was that she should call back on Monday morning. The doctor was already gone, so she couldn’t ask questions, begin discussing her prognosis, treatment, anything. Just “You’ve got cancer. Call us on Monday. Have a great weekend!” She would have far preferred an appointment, no matter how inconvenient. (Ten years later, SIL is cancer-free.)</p>
<p>I left our first pediatrician because she wanted us to come back for test results, ear checks, etc and we were charged a copay each time. Our present one doesn’t and he doesn’t believe in doing that.
A practice I worked in years ago, had some doctors that would call the patient about an MRI result, blood tests, etc. especially if they were fine, others, had them come in, miss work, pay 10-50.00 copays and 5 minutes later, they left, very upset they wasted their time. Of course if something isn’t right, they should tell you they want to go over it in person, but those are your test results, you should be told when they are ready not a week or more later.
When I had my bone density test, I asked if I could have a copy sent to me also, they said, no, so I had to wait until my ob/gyn came back from vacation, almost 2 weeks to hear anything but she does call. You do have a right to know your test results.</p>
<p>Is it possible that even if the test results are negative, he still needs to discuss a plan of action to resolve the original problem, or is that something you dealt with in the first appointment? Just trying to think why they would want you to come back in. In general, if it’s a simple, ‘Your results are negative, carry on’, they will do that over the phone. If it’s more complicated than that, they like to see you in person.</p>
<p>On the other hand, some docs don’t like to do anything over the phone whether it’s a communication preference or a way of generating more income - it’s hard to say. :)</p>
<p>If it really bothers you to go back in, call the office and tell them you don’t want to come back in to hear the results are negative and would appreciate it if they would let you know now, if that’s the case. Having your family doctor call for the results is another option (assuming you have one).</p>
<p>I would sign the paper to definitley have tests results released to my GP and call my GP to get those results. Also, I would request that they mail, and/or fax the test results to me. If I had to stop into the office and personally pick them up, I would do so. I believe that you are entitled to a copy of your medical records. You can always call for another appointment if it is needed.</p>
<p>“If it really bothers you to go back in, call the office and tell them you don’t want to come back in to hear the results are negative and would appreciate it if they would let you know now”</p>
<p>Not sure what “negative” means in this context, but what if you just get the response “they are negative”. Would that be okay? I usually say if you can leave me a “yes or no” question on my voicemail, I will call you back, and leave a voicemail answer. Other than that, it requires a conversation in person. </p>
<p>“In general, if it’s a simple, ‘Your results are negative, carry on’, they will do that over the phone. If it’s more complicated than that, they like to see you in person.”</p>
<p>What if there are 10 shades of gray in between? Are people saying they should have to come in, and the doctors should get paid, if the results are “negative”, but not otherwise?</p>
<p>A primary care doc that you trust and have a relationship with, will often know what to do, and may get reimbursed “per member per month”. Once a “specialist” gets involved, the relationships and values may shift. I don’t think this is a bad thing. Some people WANT the specialist involved.</p>
<p>BTW, I am considered by some to be a specialist, while my husband is considered by some to be a “GP”. He is not; He is a primary care doctor, but he is a family practitioner.</p>
I’d say it’s probably both. Phone communication is iffy when the topic is something is something as important as your health. It’s easier for the MD to tell that he/she is being clear in a face-to-face meeting. Now, there’s nothing hard to understand about “your tests are normal,” and I do believe normal results should be available without charge by phone. (My MD does it by email.) </p>
<p>The money thing is a complicated issue. It does seem like gouging when a follow-up visit is required just to hear about normal test results. I don’t know any MDs who do this; if many do, it’s just another reason that health care is such a mess. But if an office professional spends 3 or 4 hours per week phoning patients to tell them their results are normal, it represents an expense for the practice. I’m not saying that a fee should be involved for this service, just that there are aspects of patient care that don’t generate income for the practice and do require an expenditure.</p>
<p>Another side of the “should MDs be paid for phone calls” question: My dh is a pediatric specialist whose patients include a large number of very sick children. He shares call with three colleagues. There’s always an MD to respond in case of an emergency or if a parent calls with a concern, even at midnight or much later. Many nights my husband spends several hours on the phone talking to anxious parents, arranging for a child to be admitted to the hospital, consulting with MDs at distant hospitals when one of his patients shows up in their ER, calling pharmacies to open up for a kid who’s run out of meds, even reading EKGs by fax. He doesn’t get paid for any of it, except, recently, for some of the EKGs (those from hospitals where his practice has a contract). He’s practicing medicine when he does these things - it would seem fair to me that he be paid for it. I don’t see this happening any time soon, though.</p>
<p>I do realize now that I was not clear. I should have said “I feel like doctors who do this are holding the test results hostage, and I need to pay the office visit fee to get them.” I did go see my specialist, and I did pay the office co-pay fee, and I did get to see the scans from the test. No follow-up of any sort needed. BUT I still object to the blanket policy that no information about test results will be provided over the phone. If it’s a judgment call and the doctor decides that in a particular case, the results should be given in person, that’s one thing. But even if follow-up is needed, that can be conveyed over the phone. And maybe it’s just me, but if the results are bad, even cancer bad, I would like to know that as soon as possible. I would have preferred the message on Friday afternoon rather than a weekend spent wondering.</p>
<p>I don’t know how to address the payment issue.</p>
<p>^^ I would ask that the doctor report the test results, diagnosis, and treatment recommendations to my GP (many specialists do this automatically if the GP referred the patient to them). I would then get a copy of this from my GP.</p>
<p>In general I expect any Dr. to have his office call with good news that doesn’t require follow-up. If something requires more follow-up then of course I expect to meet with the Dr and discuss options. </p>
<p>Ultimately you’re talking about how that Dr chooses to conduce their business. As was mentioned before you can always get your test results through your primary care provider so the results can’t be “held hostage”. I would not accept any Dr’s office (with one exception) have me come back for good news and if they did that to me I would express my displeasure and remind them of the value of my time. I would also let the Dr who referred me know of my displeasure and how I was treated. </p>
<ul>
<li>the Exception - Every once and awhile you need a Dr who is so skillful or experienced in a specialty area that they can demand anything they want. And I’m smart enough to just smile and thank them… I lived in an area with limited surgical specialists. The people who didn’t know the Dr’s in town always choose one of the nice surgeons, but when any Dr/RN in town needed a surgeon they always choose a surgeon who had no bedside manner and was as a real A**, but was by far the most skillful in the OR.</li>
</ul>
<p>“And maybe it’s just me, but if the results are bad, even cancer bad, I would like to know that as soon as possible. I would have preferred the message on Friday afternoon rather than a weekend spent wondering.”</p>
<p>I work for a group of surgeon/specialists and they absolutely will not call a patient with a positive biopsy result on a Friday afternoon. They wait until Monday morning. </p>
<p>Regarding the OP comment, we will give normal results over the phone without requiring the patient to return. On the other hand, if the physician is adjusting medication, recommending surgery, or anything that requires more than a 1-2 of minutes of phone time, this will require a return visit. We have patients that want to spend 30 minutes on the phone with the doctor for “normal results”. In light of decreasing Medicare and insurance reimbursement (look for Medicare reimbursement rates to decrease 21.5% on 12/1/10 if the lame duck Congress does not stop this), they just can’t afford to spend this kind of time on the phone. Sorry off soapbox.</p>
<p>As one who has received bad diagnosies here’s my take: Call me asap. Waiting is hell. Yes, I received my cancer diagnosis on a Friday afternoon…late. I was in hysterics and to have waited all weekend: horrible. I have had several follow up tests: one for a potentially fatal bone cancer. My doctor called me the minute the results came in to say that I was ok. When the office calls to give results that means everything is ok. for routine tests.(with the practices that I am in. Please to the OP, and others, do NOT confuse medical practice here with where you live and/or the doctors that you see. Do NOT assume because the doctor wants to see you that there is a problem. This may just be his practice…no pun intended.) When the doctor calls, no so good. </p>
<p>As for the discussion of a copay: Hey, follow the bouncing ball. Fight that fight later. Find out that you’re ok, have a challenge…whatever…and then see what you can do about the extra copay. You may need this doctor. Don’t antagnize him/the office until you need to.</p>
<p>Actual phone call to my cell phone while I was driving home from the MRI: “Hi, this is Dr. X. Dr. Y called with the results of your MRI and you have chondrosarcoma. You have an appointment with Dr. Z on Friday three weeks from now to discuss treatment options. Can you make that appointment?” My response: “I have cancer? I thought I had a torn meniscus.”</p>
<p>Believe me, I would have vastly preferred being asked to come in and talk to the doctor. </p>
<p>OTOH, my primary care doctor these days emails the results of my routine blood tests with her comments. That’s fine. Just don’t call me while I’m driving!</p>