A recent Federal Court case brings to mind the devastating impact that the failure of medical professionals and medical facilities to report bad findings or test results can have on you or someone you love.
A young lady, 18 weeks pregnant, had a routine appointment with her obstetrician during which she had an ultrasound. The sonographer reported to the doctor that the findings were abnormal. The doctor instructed the sonographer to arrange for a follow-up ultrasound and a consultation with a specialist. Through a series of miscommunications on the part of the medical facilities, the young lady was not informed of the abnormal results and the appointment with the specialist was never scheduled. Compounding the error, the young lady had five additional regularly scheduled appointments with that same obstetrician over the next several
months, but still was not informed of the abnormality. Finally, just a few weeks before her child’s birth and far too late for doctors to help, she was given the devastating news that he would be born with profound birth defects if not stillborn.
If you think this is an isolated incident, you would be wrong. A 2009 article published in the Journal of the American Medical Association indicates that the “failure to inform patients or to document informing patients of abnormal outpatient test results are common,” occurring in 7.1% (about 1 out of 14) of the cases they studied.
No news isn’t necessarily good news when it comes to medical tests. As the above study indicates, patients often fail to receive needed follow-up care because serious medical test results are lost or overlooked. Lost test results leading to a missed diagnosis or a delay in treatment can be life-threatening for patients and may be actionable as malpractice against doctors. While sometimes bad medical outcomes happen without a doctor’s error, not telling someone about a bad test result or not ordering necessary following up care is medically and legally inexcusable.
The article does, however, contain some good news, including insight into ways that you can help to protect yourself. The study indicates that doctors and facilities with thorough and institutionalized processes for reporting and acting on test results had a much lower failure rate. Moreover, doctors who maintain a fully electronic medical record [EMR], as opposed to partial paper or no EMR at all, also have lower failure rates.
Based on these findings, you should ask your doctor or your testing facility some very important questions:
- Do they maintain a full EMR? If not, what is their procedure for making sure that you know your test result?
- Do they and how do they route results to the responsible doctor?
- Do they have the responsible doctor sign off on the results?
- Do they inform patients of all results, normal and abnormal?
- Do they document that the patient was informed?
- Do they tell patients to call the office if they fail to receive their results within a certain time period?
You should also ask your doctor the following questions about medical tests:
- Why do I need the test?
- What information will the test provide?
- Is this the only way to find out the information?
- What are the benefits and risks of having the test?
- How do I prepare for the test?
- When will I get the test results, and how will I get them?
- What is the next step after the test?
You can also help yourself by calendaring a follow-up call. Note when you should expect to receive your results and call the office if you don’t receive them before that time.
Communication between patients and medical professionals is another issue all to itself. The most common complaints about doctors are that they do not spend enough time with their patients and that they do not value your time as much as theirs. Research demonstrates that patients see doctors as authoritarian – difficult to approach – and thus do not ask important questions of their doctors for fear of being labeled “difficult.” Doctors, on the other hand, get frustrated when patients do things that hamper their patients from collaborating regarding their own care. So, you should select a physician that you feel comfortable communicating with and who is receptive to your questions. You also have to be willing to bug your doctor’s staff to get your test results – it might actually be a life or death issue.