On Monday, the Obama administration announced new rules which allows patients to get lab results directly from the lab that ran the tests without consulting the ordering provider. This is part of an effort to empower patients as consumers and reduce errors. It has been postulated that this will give consumers of healthcare more control over their own health. But, does this really invest them or set them up for more problems?
In my office, the blood is drawn by the nurse and my patient rarely goes to an actual lab. The results are sent to me electronically and then interfaced directly into my electronic health record for each specific patient. We typically receive test results the following day and the patient already has had a follow-up appointment scheduled to discuss the test results. A copy of the results are provided to the patient at their follow-up visit and their questions answered and all test results are explained to the patient. A patient may additionally request a copy of their lab results without an office visit. I will give them a copy of it after reviewing it to make sure there is nothing urgent that needs to be addressed. If there is a critical lab value, I will ask them to be seen to discuss it with me when they come to pick up the copy of their test results.
If a patient were to obtain a copy directly from the lab, they would not receive appropriate counseling regarding the lab results. Sometimes, normal lab results can be as significant as abnormal ones. A patient may falsely assume that all normal results signifies that no further work up is indicated. In many instances, this is simply not true and the patient may be setting themselves up for missed diagnoses. As the ordering physician, I am responsible for the test results. But, we all know how phone tag is played out these days. And many patients are reluctant to return calls from their physicians.
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Similarly, there are some abnormal lab results that may be completely insignificant. This may lead to undue worry and stress on the part of the patient. Dr. Google does not always know best. Sure, the internet can educate and empower patients. But, the physician ordering the lab tests was looking for a specific result or to rule out a particular abnormality. Dr. Google is not privy to your doctor’s thought processes.
While empowering patients is a great goal, we need to do it in a safe and reasonable fashion. While patients are entitled to their test results and they are the true owners of them, discretion should be used in how they are handed over. As physicians, we took an oath to do no harm. Allowing needless worry is not acceptable. Additionally, if we allow an avenue where patients may slip through the cracks to take hold, we are not really empowering patients but setting them up for future problems. If we want the patients to take true possession of their health care, let them have access to all their results, but not without proper consultation where they can get all their questions answered and concerns addressed. Handing over a piece of paper with a bunch of results and letting them Google it is not really the route to achieve this.
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