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Don't Doctors Have "Rules" about Giving Test Results?

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Posted 3/15/2011 1:17 PM (GMT 0)
I had my second post surgery PSA test done last Friday. I told myself I was not going to anguish over the test and just let the results get mailed back to my by my internal med doctor. I don't use my urologist/surgeon for PSA testing. I get it done with my internal med Dr. So by Saturday, I put the test out of my mind.

On Monday evening, My doctor left a name and number with no other information. The last time he did this was when he called when my initial PSA test had gone from 3.4 to 6.9. That call started this whole nightmare of consultations, biopsy and finally, surgery.

I knew I would not sleep last night with this hanging over my head so I called the on-call doctor covering for the evening. Fortunately, my doctors are well entrenched in the 21st century and lab results are on a networked computer. The on-call dr. called back within 30 minutes and I could hear in his voice the question as to why this crazy guy was calling me at 8:00 pm in the evening just to get his PSA results.

Anyway, he said it was >0.1 undetectable. I thanked him and confirmed that the results were from the March 2011 test not the previous 2010 test. Sometimes you just need to hear the results repeated to let them sink in to your brain.

So, don't doctor's have rules about when they call and what they say? Shouldn't good news answering machine messages hint a bit that the call is of a positive nature? I realize HIPA rules apply when leaving messages on an answering machine. If my wife were home and answered the call, by law, he could not give her the results without my permission. My main concern is when a doctor calls. Either call for all test results or only call for bad ones. Just make it consistent.

The phone message incident even made me forget that my pad measurement was only 7 cc for the entire work day. Not a new low but I only hit 7 cc once before in late February. A glimmer of light on the horizon I hope.

Mike S.
Posted 3/15/2011 1:53 PM (GMT 0)
Congrats on the good results, now back on track and onward and upward with your other parts of the recovery.
Posted 3/15/2011 1:57 PM (GMT 0)
Congradulations on the result.

Our Dr Office will only leave a message on an answering machine, if you mark it on your record.  If you don't, they only leave a return call message.

 

Posted 3/15/2011 2:34 PM (GMT 0)

I'm just happy that my Doctors call/call back when requested tongue

The thought of a message saying he or she has horrbile news and that I can wait till the morning if I want, wouldn't work well for me.

On the other hand - test results are what they are so I don't get nervous waiting for the results.

Posted 3/15/2011 2:53 PM (GMT 0)
Even a great doctor can have a slack staff. My uro specifically instructed his nurse, to call me asap as my recent bone scan came back. After waiting 4 days, I had to call, and sure enough, they had the results back for 2 days, leaving me to worry an extra 2 days. When I tell him, he will be furious with her.
Posted 3/15/2011 2:56 PM (GMT 0)
Mike,

You knew you had a 99.6% chance it would be <.1   You are now on yearly testing if you want.

Chris

Posted 3/15/2011 4:49 PM (GMT 0)
Chris: I knew you would say that and I believed it as well. I was just wondering what went so horribly wrong with my test that he would be calling me about it. I did get a call from him at work this morning. He just wanted to touch base. I guess some of the rewards of being a doctor are to make easy calls with good news rather than then tough ones that you know will produce anxiety.

Purgatory: Last time when I talked to the office staff to get the actual test number since the computer spit out the 1st post surgical test paperwork with this remark: PSA Test: NORMAL When I asked for the numbers the "less than" symbol "<" was a bit of a challenge for the staff member to handle. It is ashamed that math education has to come to saying over the phone. "OK, just before the numbers listed, the thing looks like the letter V only it is sitting on its side and the pointy end faces to the left. Good grief, we are ripe for a takeover if we keep this level of education going in schools. Weapons officer to commander: Sorry, I missed the enemy ship headed into our harbor, I could not figure out that mathematical coordinates for the trajectory of the rocket. Ops!

Given the lab test computer's thresholds, if I do get the hardcopy sent to me, the term NORMAL could be anywhere from .1 to 4.0. "Normal" just does not cut it with anyone and I am surprised that they dumbed down the test results they send to patients. The test result printout is geared for those who still retain a prostate.

Thanks to everyone for the good wishes and congrats. It means a lot to confer with all of you.

Happy Motoring Everyone. I finally get to update my signature....
Mike S.
Posted 3/16/2011 12:45 AM (GMT 0)
There have been times I'll get a call from the doctors office telling me I have to come in for the results. They have never left a message.
My dad had terminal cancer resulting from PC. His doctor's office called my brothers house to talk to my dad he was not there. Nurse said they wee just wondering how he was doing since he had turned down chemo. My father had never told us how bad he was or that he turned down chemo. We never told him we knew. The nurse should have never talked to my brother. He died 4 months later.
Posted 3/16/2011 2:05 AM (GMT 0)
Congratulations on the excellent test results.  Instead of looking for the negative I suggest you concentrate on the positive.  I think your MD handled the call appropriately.  Best wishes for continued positive results in the future.
Posted 3/16/2011 3:32 AM (GMT 0)
When it's REALLY bad news, they usually say: "The doctor would like you to come in so he can talk with you..."
Posted 3/16/2011 3:44 AM (GMT 0)
Mike,

I have the report mailed to me. You should, too.
There is a "cc" box on the request form and I make sure they put my name there with the word "patient". The report shows up at my door in 2 or 3 days and I have a record. I am also sure the little pointy thingy is facing < or > and the number is 0.01 or 0.10.
There is no excuse for someone at a doctor's office to not know what the pointy thing means. (I noticed you wrote it backwards "it was >0.1" ) I want that piece of paper so I am sure.

Congratualtions!

Jeff
Posted 3/16/2011 1:23 PM (GMT 0)
Mavica: I am trying to look for the good in all of this and adding some humor as well. Actually, my doctor called and apologized the next day. He understood that leaving a cryptic message was inappropriate in my case since the only other time he left a message it was bad news. My point is that it is useless to leave a message that has no content. Actually, my doctor said the only reason to leave a message was to put the "ball" in my court and have me initiate the next call. I also realize that HIPA would not allow the dr. to leave the results on the phone. So, just send the test results in the mail and be done with it, ESPECIALLY, if the results are benign. That is what I expected and the reason I did not want to inquiry myself in the first place. Yes, doctors are human and in the rush to be efficient they don't realize that a simple phone message can be misinterpreted. I can't wait for the results to come back with the words "Normal" in the comments line for the test. As stated before, the computer program that runs the printout for the test is not geared for the post-prostatectomy patient.

Worried Guy: Ops! I did screw up the less than symbol. Hey, the two keys are right next to each other and I messed up. Staff not knowing the symbols: We assume that everyone has had a uniform high school education but that is just a dream. Check box? I just call in the request for my test and then pick up the dr. order printed out on paper before I take it to the lab. No check boxes, nothing to sign or anything. No uniformity in the labs in this country I guess. My solace is that my internal med doctor is tied into the same system as my urology surgeon downtown at the hospital so any of them can log in and see my results. The lab is good as well. The send all samples downtown where the main lab has gotten multiple service excellence awards. Not a perfect system but pretty good overall. I do get the report mailed to me and it does have the actual test numbers but then that darn "Normal" will appear as well because the computer has the thresholds preset for <0.1 to 3.9 ng/mL as the "safe" range. Same for when I get a blood work-up. The computer provides ticks for anything that is out of the normal range. That alerts the doctor to call the patient and leave the same nondescript message that I got.

Ger42: Sorry for the loss of your dad. You present a very tricky grey area in your comment. Yes, it was your father's business that he not take chemo and not inform any of you. The nurse was concerned that your dad has dropped out of the protocol and called. Your're right she should not have shared his treatment information with all of you. This is where HIPA and compassionate concern butt heads. Perhaps not in your case, but what if a simple treatment could have been curative but an elderly patient expressed negative feelings about treatment for no rational reason and refused treatment. The phone call from a nurse or doc could be a life saver but if you follow HIPA strictly, the concern by the med staff should not be conveyed to the family.

Have a good day everyone.
Mike S.
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