Patients Not Always Told of Lab Results
Researchers Say Doctors Need to Do a Better Job of Informing Patients of Lab Test Results
June 22, 2009 -- Primary care clinicians and their staffs sometimes fail to inform all patients of the results of lab or screening tests -- or fail to keep records that patients were informed and thus have no proof, says a study in the June 22 issue of the Archives of Internal Medicine. That poses potential dangers to consumer health and possible legal troubles for doctors, researchers say.
"There is a disconnect in many offices, and this is alarming," Lawrence P. Casalino, MD, PhD, of Weill Cornell Medical College, tells WebMD. "Some patients aren't being told about the results of tests, and this shouldn't happen. The takeaway message for consumers is clear -- if you don't hear within two weeks, call your doctor's office."
Failure to Inform Patients of Lab Test Results Is Common
Casalino, lead author of the study, and colleagues reviewed the medical records of 5,434 randomly selected patients between the ages of 50 and 69 in 23 primary care practices.
They identified 1,889 abnormal test results and 135 apparent failures to inform the patient or to document that the patient was informed. That’s a rate of 7.1%, or about one out of every 14 abnormal tests.
Practices that used a combination of paper and electronic records had the highest failure rates, the researchers say.
No News Isn't Always Good News
"Most [practices] did not have explicit rules for notifying patients of results, the researchers write. "To our knowledge, this is the first study to estimate the failure-to-inform rate across a variety of tests and types of medical practice." Casalino tells WebMD that "patients should never assume that no news is good news" because "a lot of things can go wrong in the office. Some may never receive a report from the lab, or it may come in but the doctor never sees it and it might get filed away before he does."
He tells WebMD that many primary care doctors' offices are swamped with paperwork, making it easy for test reports to go to the wrong place, or the right place and not be seen, and that often procedures are not in place to make sure doctors see and act on lab results.
"Doctors should at the least mail out a form and keep a copy in the charts," he says. "In our research team, it turned out that almost everybody had a personal experience with a missed communication."
Electronic Records No Help
Co-author Daniel Dunham, MD, of the Northwestern University Feinberg School of Medicine, says switching to electronic records systems won't solve the problem.
"An electronic record is a tool that can help improve or facilitate communication, but you need processes in place to deal with labs," he tells WebMD. "And, many things can go wrong. It could be the doctor had the wrong phone number, or the wrong address. To this day, we tell patients the responsibility is on us to communicate with them."
But the backup for patients should always be to call their doctors if they aren't notified of the results of tests, Dunham says.