“Whilst she was there” the patient asked if I had her test results. She had some blood tests done about six weeks ago that a colleague had ordered and had been meaning to check them but she hadn’t heard so she assumed everything was ok. I winced at the word ‘assumed’. It’s a nasty dangerous word with a vicious bite.
She’d also had a scan a month ago that a specialist had organised and hadn’t heard the result. Frustratingly, for me, the patient hadn’t phoned the hospital to see what the scan result was or asked my colleague who she’s previously seen and who had arranged the blood tests. No. Now she was asking me, ‘just whilst she was here’.
The consultation had already dealt with some benign looking skin lesions that she was anxious about and I had taken photos, including super-duper close up dermoscopy. I said I would send the snaps to the local dermatologist for their view. All that had taken the entire ten minutes allocated to her.
I bashed the keyboard for a few moments and found the results. I told her that the blood test results showed she had severe anaemia, renal failure, liver failure, diabetes and an underactive thyroid. She looked shocked. She asked why we hadn’t told her. I assured her the records showed we’d tried to phone her three times and we had sent her a letter to ask her to get in touch. She said she hadn’t received any missed calls from us (though our calls are anonymised, for confidentiality, so she couldn’t be sure. She doesn’t tend to answer unidentifiable calls she told me, and we don’t leave messages in case someone else hears them). The letter must have got lost in the post. Is her address up to date? For that matter is her phone number up to date? I said, as if were a contract, that it also states in our practice leaflet that we encourage all patients to make sure they find out their test results a week or so after the test. Some practices do have ‘contracts’ with their patients. I can see the benefit here.
The reason we ask people to check their results is, believe it or not, we’re human and sometimes an abnormal result gets mis-filed as normal, or an instruction to phone a patient gets accidentally, deleted, or a well-intention-ed attempt to call a patient gets interrupted by a developing emergency and forgotten. We are human. These things sometimes, rarely, do happen. Every practice in the land will know of a time when it has happened. Really.
Most GP practices will regard that advising patients to chase their test results is a safety net. They know they have professional obligations to tell patients when their test results are abnormal and have systems in place to make this as safe and reliable as possible. In all though, there a lot of possible reasons why those systems might fail and why a patient might not be informed of a result. The sample might get dropped and break – that should usually lead to an ‘unable to process’ report. The sample might get dropped and lost. (That shouldn’t happen very often. We have quite secure blue bags for transporting samples, but it’s not impossible). The electronic systems for sending a result to the surgery might have a badly timed glitch just as your result is being transmitted and never get recorded in the GP system. That too is rare but our electronic systems are not infallible. Are yours? Phone numbers and addresses may not be up to date. Electronic and snail mail does not always reach its destination.
The hospital doctor had written to the patient with the result of her scan and asked her to contact his secretary urgently to make an appointment to discuss the scan. I had a copy of the letter on my system. Such a letter would normally put the fear of God in most patients. Not this one, because she didn’t receive it, but I could see she was sweating now. I hadn’t done anything about it because I’m not her nanny. I’ve got quite a lot to do as it is, and as the scan was of her and ordered by someone else, I also kinda thought she might have been more interested in the result, than I. It’s not that I don’t care. I just can’t care enough for every patient. It would literally kill me.
Because she hadn’t cared enough about those results either she was risking her life too. But luckily for her I was joshing.
They were all completely normal. She didn’t have liver failure, diabetes renal failure an underactive thyroid, anaemia or anything wrong with her scan…. but she needed to learn the lesson. Some would call me a cold hearted bastard for playing such a trick, and if this were true I would be, but it isn’t. It’s just a story to help you remember:
Always check your test results, with the clinician who ordered them and assume NOTHING!
None of us want ASS-es made of U or ME. That’s what happens when you ASSUME something you shouldn’t. Always check your test results, with the clinician who ordered them. Hospitals, GPs and almost all patients have had phones for a long time. Yours goes with you everywhere. Next time you have a test, use it, not for social media but to actually telephone the NHS to check out those results. We will try to tell you, but we’re human. Be a good safety net – for your sake please!