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Bad Test Results Often Go Unreported

By CARLA K. JOHNSON
,
AP
posted: 6 HOURS 26 MINUTES AGO
comments: 24
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CHICAGO (June 22) -- No news isn't necessarily good news for patients waiting for the results of medical tests. The first study of its kind finds doctors failed to inform patients of abnormal cancer screenings and other test results 1 out of 14 times.
The failure rate was higher at some doctors' offices, as high as 26 percent at one office. Few medical practices had explicit methods for how to tell patients, leaving each doctor to come up with a system. In some offices, patients were told if they didn't hear anything, they could assume their test results were normal.
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"It really does happen all too often," said lead author Dr. Lawrence Casalino of Weill Cornell Medical College. The findings are published in Monday's Archives of Internal Medicine.
"If you've had a test, whether it be blood test or some kind of X-ray or ultrasound, don't assume because you haven't heard from your physician that the result is normal," Casalino said.
Practices with electronic medical records systems did worse or no better than those with paper systems in the study of more than 5,000 patients.
"If you have bad processes in place, electronic medical records are not going to solve your problems," said study co-author Dr. Daniel Dunham of Northwestern University's Feinberg School of Medicine.
Dr. Harvey Murff, a patient safety researcher at Vanderbilt University Medical Center who wasn't involved in the study, said the researchers gave doctors "the benefit of the doubt" and still found a significant problem.
The researchers chose tests findings in which any doctor would agree patients should be informed. And they gave doctors a chance to explain when they found nothing in medical charts showing patients had been notified of bad test results.
The tests included cholesterol blood work, mammograms, Pap smears and screening tests for colon cancer.
Failing to inform patients can lead to malpractice lawsuits and increased medical costs, the researchers said.
"If bad things happen to patients that could have been prevented, that will lead to higher costs and in some cases considerably higher costs," Casalino said.
Researchers reviewed the medical records of more than 5,000 randomly selected patients, ages 50 to 69, in 23 primary care practices in the Midwest and on the West coast. They excluded dying patients and others with severe medical conditions where informing a patient would be redundant.
They surveyed doctors about how their offices manage test results. The offices that followed certain processes — including asking patients to call if they don't hear any news — were less likely to have high failure rates.
The study was funded by the California HealthCare Foundation.
"Our goal is not to indict physicians," Dunham said. "It's about working smarter and getting processes in place."
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Copyright 2009 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. Active hyperlinks have been inserted by AOL.
2009-06-23 03:05:23

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Sailorant7

02:20 PMJun 23 2009

I am a retired American Merchant Marine Officer living in Costa Rica. The doctors here will run circles around American doctors. Every test you take and I mean every test you get a copy of for your records. You paid for them, they're yours. X-rays,cat scans , blood tests,the works. The doctor will explain everyone. In the case of cholesterol tests and other tests also, the range is given on the results of every test. IE.Your total cholesterol is 170. Then alongside that is the range, less than 200 normal and so on. They also give you a CRP test for a little more money, also after all the tests are done they give you your risk factor for heart attack using the Castelli scale. Castelli was the Doctor who was in charge of The Framingham Heart Study. I can get all these tests done for $60.00 to $80.00 depending on the lab. I pay all my medical out of my own pocket.Sailorant7@hotmail.com

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Sworth5487

02:16 PMJun 23 2009

To Jodylrwebb: I lived in the UK for a decade and received the benefit of it's National Health System. it shows that you were only an observer. NHS is a good, fair system. The waiting lists are for "minor" conditions. The more serious, the higher on the list. As for the denistry, it's up to the patients to see their dentist before the problem gets out of hand necessitating extractions. The excellent state of my teeth today is due to the UK's NHS. I have two crowns and several fillings, but everything else is my own.

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Yakami11

02:16 PMJun 23 2009

I have a blood disorder that was going on for two years. I wasnlt told about it from my lab tests or referred to a hemotolgists until I was beside my self in symptoms. So now I get copies myself and read them and I;mnot shy about talking to a doctor.,

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Sadiemae1214

02:12 PMJun 23 2009

Been there, done that. My fiance developed a small knot on his jaw and went to the doctor. The doctor said it looked like an abcessed tooth and for him to go to the dentist. The dentist pulled some back teeth, gave him antibiotics and sent him home. The knot went down just a bit but the pain persisted. Turns out that he had oral cancer. The only test that was done was a bioptsy, AFTER THE FACT. He passed away 11 months later.

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LaurenceWife

02:12 PMJun 23 2009

most doctors want to know how and where they pay will come from and good riddance.

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Yakami11

02:11 PMJun 23 2009

Tell them you will need a copf f th ereport after and a copy of the film. Most require you follow up with your doctor and will say get a copy from him but it;s hard to get that sometimes. So tell them you will need a copty. Read the whole report. Indications will appear throught the report but ,ost doctors will breifly check the findings section. Point out the whole report to him. They should sit down and explain if all and gove you a copy anyway but they dont. So make sure you ask for one. You may need it dowen the road with another doctor.

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NNancieJean

02:07 PMJun 23 2009

Orbitxal1 01:20 PMJun 23 2009 President Obama's health care will make my life better BECAUSE I won't be bankrupt from medical bills and lose my home and everything else............And you won't have to worry about getting the correct results from your tests. Because health care will be rationed and oddds are you won't get the needed tests. So I guess that will work out better for you. No news is good news.

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TBLTTX

02:06 PMJun 23 2009

The problem is that doctors just care about money, and damned be the follow-up. I know, because I am a former RN, Advanced Nurse Practitioner and Certified Registered Nurse Anesthetist who is now disabled. The health care system has deteriorated so badly in the last few years. Don't believe that malpractice plays as large a part in the costs and the care. Most medical boards will DO NOTHING TO STOP PHYSICIANS WHO SHOULD NOT BE PRACTICING. I practiced for 25 years and was sued once, and that was because I gave the anesthetic on a C-section where the Doctor TOTALLY BOTCHED IT. He then claimed I had delayed the C-section, which was a lie, and I proved it, but he got me pulled into the lawsut with his lies. I have some good doctors who communicate well, but I have one whose office and the communication IS A NIGHTMARE. In TX, they will never, ever do anything to a doctor over anything so THE DOCTORS DON'T CARE.

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HardingFRN

01:57 PMJun 23 2009

There have been some rather interesting assumptions the medical community has taken at times one was that if you didn't hear back from them everything was OK. I'm in business and our assumption is that if you didn't hear back ; you haven't been contacted yet.

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Megan1582

01:57 PMJun 23 2009

This is exactly why my family sued our family doctor! They had run some blood work and other tests on my father and nver even looked at the results. Someone filed them away in my father's chart and no one called, no one ever even saw the results. A year later we learned that if we had gotten the results in time my father most likely would have been well enough for a bone marrow transplant, which he actually had a match for! But since nothing happened for a year, he was too sick and passed away about a year after that!!! He was only 52 and left behind a wife and two teenage daughters. These are people's lives! Someone needs to be held accountable!

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