Bad Test Results Often Not Reported to Patients

Doctors in the United States fail to tell patients about abnormal test results 7 percent of the time, or a rate of about 1 out of every 14 tests, U.S. researchers said Monday.

They said electronic medical records, which many experts tout as a way of reducing errors, did not reduce and, in some cases, slightly increased, the chances for these kinds of mistakes, they said.

“The electronic medical record doesn’t magically fix the problem,” said Dr. Lawrence Casalino of Weill Cornell Medical College in New York, whose study appears in the Archives of Internal Medicine.

Not telling patients about abnormal test results can delay treatment of cancers or heart disease, hurting the patient’s chances of survival and exposing doctors to malpractice lawsuits.

“Failure to diagnose is one of the most common causes of malpractice suits,” Casalino said.

Casalino and colleagues analyzed more than 5,000 patient records from 23 physician practices across the country, looking at screening tests for conditions such as high cholesterol, diabetes, blood tests for colon cancer, and mammograms.

They found that doctors failed to inform patients 7.1 percent of the time. Performance at individual practices varied widely. Some practices always informed patients, and some failed to inform patients 26 percent of the time.

Physician offices that used a combination of paper and electronic records — a so-called partial electronic medical record — had the highest failure rates, while there was no significant difference between practices that used only electronic medical records or paper records.

Doctors should have explicit rules for informing patients of test results Casalino said, adding that all results should be sent back to the doctor who ordered them, and patients should be told the results of all tests, even if they are normal.

And patients should make sure they ask their doctors for the results of all tests, he said, noting: “Don’t ever assume that no news is good news.”

Copyright Reuters

Comment: For years i have told my patients that they need to follow up on lab tests even if the phonecall from your doctor says all values are normal. Why? Because lab values have normal ranges and whether your results are at the high or low end of the range is a clue that something is out of balance in your body. Studies are showing that the “normal” ranges for some tests are much too wide creating an abnormal sense of security. Of course we all want the call that says everything is normal but at least take the extra step to get a copy of the results-you are paying for them they are yours. Then if your condition is still suspect you can at least take them to another health practitioner for a second opinion. -Dr B