When you see any doctor who orders  one or more tests, ask some questions.

“Why am I having this?”

“What will this test tell us?”

“How reliable is this test considered to be?”

“When will my test results be in?”

If you hear back, “Oh, I will call you,” don’t let that be the end of it.

No news is no news. Period.

Patients don’t want anything to be wrong. When they hear nothing, many think, “Good. It’s OK.”

Doctors who are good communicators will tell their patients something like this. “Normally, these test results come in in (three days, one week, whatever applies). If you don’t hear from me by ______, you call me.”

Too many mishaps can occur in the trip from doctor’s office to lab and back again. Too many busy radiologists can be swamped with imaging studies to evaluate.

So many tests are ordered in the course of any day, it is too easy for an order to get lost or a report to be delayed.

Should you be concerned that you may have a serious problem, if at all possible, do not have the test going into a long weekend, such as Memorial Day, or over a big holiday, such as Christmas, if you can possible avoid it. Sometimes, you can’t.

Labs get backed up. Emergencies always will come first, as they should.That means all of the other tests which came in just as the holiday started have to get a place in line all over again.

You, or a patient you are concerned about, will have additional waiting time and the stress of waiting to hear what cell type the cancer is, for instance.

Since many doctors use the same labs, a request to “rush” results is relative.

“Rush” means, to testing centers, as fast as they can get to it after they have done what they must do first—-emergencies.

At times when you may have no choice about having a test before a holiday, your doctor’s office staff may be able to help you a lot. They can find out where your test is in the process and when it is likely to be completed. Depending on the situation, there may be other ways they can help get information for you sooner rather than later. There are no guarantees of this so do not expect it but it cannot hurt to ask.

An experienced doctor’s office staff knows how to wheel and deal with the labs they deal with most often. Smart patients do not make demands. Simply ask for help. “I am really worried about this. Could you find out when we will get the report? If you can do anything to get the report back sooner, I’d appreciate it.”

One more time: When it comes to any kind of medical testing, no news is only no news.

You have to make sure that the tests came back. You have to be sure to find out what the report said.

You also want to be ask if the doctor noted the test results in your file. One year from now, you won’t remember and neither will your doctor what that test said. Was it slightly below normal last year?

The story below points out that some doctors communicate results but don’t note those results in the record.

One reason specialists or new doctors repeat tests which you already have had is that they want to be sure that a lab or imaging center they know and trust has evaluated the findings. There are simply too many ways for test readings, results or reports to be flawed to take a chance. If you were a doctor, you would not want to take that chance, either.  When it comes to tests, and especially common ones, it pays to be double-check. Besides, things change. If your test three months ago was normal and the one from last week shows a change, that is actionable information.

Many screening tests are not all that accurate. That test may be the only one there is. One kind of test may well known for producing too many false positives or false negatives but it is better than nothing. Doctors know which ones those are. Repeat testing also is ordered in those situations. Even tests known not to be the most reliable can produce trending information. Is this level going up or down?

If you are checking on test results for a patient, you have to have a signed release form from the patient on file or they will not tell you, citing patient privacy as the reason. A doctor has to know that you are, in fact, authorized to get this information by the patient. In a serious situation, get that consent in the file quickly so you can collect information for a patient who is unwell or who does not want to make these calls.

New York Times

“If you think your doctor will automatically tell you if you have an abnormal test result, think again. Researchers studying office procedures among primary care physicians found evidence that more than 7 percent of clinically significant findings were never reported to the patient.

“The scientists, led by Dr. Lawrence P. Casalino, an associate professor at Weill Cornell Medical College, reviewed the records of 5,434 patients at 19 independent primary care practices and four based in academic medical centers. They extracted records that contained abnormal results for blood tests or X-rays and other imaging studies, and then searched for documentation that the patient had been properly informed of the problem in a timely way.

“Then they surveyed the doctors with uninformed patients. Some told them that the patient had been informed, even though there was no documentation, while others believed the results were not significant and therefore required no notification. In a few cases, the doctor said that the patient had not yet been informed but soon would be. After accounting for these and other ambiguous cases, the researchers found that of 1,889 abnormal results, there were 135 failures to inform.

“Results varied widely among the primary care practices, and all but the smallest — those with fewer than eight doctors — had at least one failure. In two of the largest academic medical centers, with a combined 80 primary care specialists, 23 percent of abnormal results were never mentioned to the patients.” (Emphasis added)

Source: New York Times, June 22, 2009