Another argument for patient's access to their test results

Hoffer, Edward P.,M.D. EHOFFER at MGH.HARVARD.EDU
Wed Apr 23 10:58:17 UTC 2014


I tell my patients that while few doctors would consciously ignore abnormal test results, a small percentage of test results get lost by the lab, misfiled, sent to the wrong doctor who discards them, etc.  Hence a “closed loop” is much safer than “no new is good news.”
Ed

Edward P Hoffer MD, FACC, FACP

From: Peggy Zuckerman [mailto:peggyzuckerman at GMAIL.COM]
Sent: Monday, April 21, 2014 12:18 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Another argument for patient's access to their test results

Quite similar to this is the very frequent situation in which a patient is told re the blood labs, "We'll call if there is a problem; otherwise, don't expect to hear from us".  Stats indicate that some 15-18% of labs with abnormalities are not reported to patients.  With the millions of tests done, that percentage reveals a tremendous weakness in our system, and another reason to be pro-active in getting and reviewing one's own labs.
Moreover, that statistic does not indicate whether the reported problems suggested by the abnormal labs ever trigger the proper follow up, not to mention are used efficiently in the diagnosis.  Case in point:  a PSA test is higher than normal, and patient is told to see specialist.  Is there a formal referral, are the abnormal labs provided to the new specialist, are new labs prescibed, does the GP inform expect and prepare for a response from the specialist?  No stats on any of that, which are certainly "delayed diagnosis" incidents.
If these labs and the value of them were EXPLAINED to patients, so that they understood the importance of the abnormal reading, more appropriate follow up by both patient and doctor would happen.

Peggy Zuckerman

On Sun, Apr 20, 2014 at 8:02 PM, Graber, Mark <Mark.Graber at va.gov<mailto:Mark.Graber at va.gov>> wrote:
In a very disturbing story this week, a radiology tech was accused of notifying 1000+ women that their mammagrams were normal, although she didn't know this to be true, and some in fact were not.  http://www.today.com/video/today/54989210#54989210

Its my understanding that all women are supposed to receive a copy of their test result, and its not exactly clear from this report if the tech just gave women a verbal 'ok', or if she actually altered the radiologist's report.  This is a class of diagnostic error I've never encountered before, but I'm hoping that the directly-mailed results mitigated the tech's false assurances.  If anyone has access to more facts on this case, I'd be interested to hear them.


Mark L Graber, MD FACP
Senior Fellow, RTI International
Professor Emeritus, SUNY Stony Brook School of Medicine
Founder and President, Society to Improve Diagnosis in Medicine
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Peggy Zuckerman
www.peggyRCC.wordpress.com<http://www.peggyRCC.wordpress.com>

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