Test Results From Your Doctor - No News Is Not Always Good News
You would think that being diagnosed with cancer was bad enough. But what if you discovered that a “communication glitch” resulted in a delayed diagnosis of your cancer? A delay that resulted in your being diagnosed as a Stage IV cancer patient with a 5% life expectancy at 5 years instead of Stage I with an 85% life expectancy. How would you feel? Angry? Disgusted? Disheartened?
This isn’t a hypothetical question. According to a 2007 study of California primary care physicians, approximately 20% of patients “may not have received timely or appropriate follow-up on positive (abnormal) test results.” Remember, primary care physicians are the first line of defense against a life threatening condition like cancer. The study, conducted by the California Healthcare Foundation, concluded that such follow up delays “can lead to complications and delays in treatment.”
Don’t think that cancer patients get any special treatment when it comes to failure to diagnose or delay in diagnosis. In a 2004 Journal of General Internal Medicine article, Communication Factors in the Follow-up of Abnormal Mammograms, 33% of women with an “abnormal mammogram” did not receive adequate follow-up care from their providers.*
The reason? A breakdown in communication between the physician and patient.
Among those women that received inadequate follow-up, researchers found that their physicians did not tell them that they needed to follow up their abnormal mammogram. In addition, these same physicians tended not to document in the patient’s medical record the follow-up care plan for women with abnormal mammograms. Such documentation, among other things, serves to “remind” the physician what they need to address with the patient during subsequent visits.
Some may find these findings somewhat startling. I know I did. But it turns out that failure to diagnose or delay in diagnosis has been a problem in the U.S. healthcare industry for sometime. The 1999 Institute of Medicine report, “To Err Is Human,” documented the significant risks posed by such unsafe healthcare practices.
The Take Aways?
Do not assume your doctor will remember to tell you about your lab or test results whether good or bad.
- Always ask your doctor for a copy of the written results of any lab or radiological test.
- If your results are “marginally” abnormal, ask your doctor what that means?
- Ask your doctor what the long-term plan is for a re-testing in the event of an abnormal test finding.
*According to the American College of Radiology, 3% of mammograms performed in the United States are read as “abnormal, with up to 3% of these women actually having breast cancer.
Journal General Internal Medicain 2004;19:316–323.
Uncoordinated Care: A Survey of Physician and Patient Experience 2007, California Healthcare Foundation