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Should your doctor's office even bother to call if your test is normal?

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Posted 4/29/2014 2:55 PM (GMT 0)
I had an initially somewhat concerning experience yesterday morning which turned out to be nothing. Having got back from running an errand, I saw "Missed Call" on my answering machine, so naturally I clicked to hear the message. It was from Kathleen, my regular nurse at my uro's office.

"We got the results from the urinalysis at your last appointment two weeks ago, and Doctor C----- asked me to call and discuss the results with you."

Uhhhh Ohhhhhh, I immediately thought. They wouldn't be calling me about this unless there was some kind of a problem! So I immediately called back, frankly beginning to get a little nervous. Got the receptionist, who of course had to put me on hold a couple of times, then spent time trying to figure out where Kathleen was, and whether she could even talk to me right now, dragging this whole thing out. But luckily I did get nurse Kathleen on the phone after a few minutes, and she simply said:

"Your urinalysis results came back normal, except for a slight rise in your white blood cell count, but Dr. C---- thinks it's okay, and there's no need to do anything about it unless you start having symptoms."

Well, having been waiting to exhale, I exhaled (not into the phone of course), thanked the nurse for the good news, hung up, and went about my business for the day, rather relieved of course.

So I was wrong in assuming that they wouldn't be calling me unless there was a problem. Well, there was a problem, but no where near the kind of thing that I had allowed my imagination to run away with.

My point: If a test gets an "okay" result, wouldn't it be just as well for the doctor's office not to call the patient about it, that is, "no news is good news?" And thus avoid the inevitable build up of anxiety in a patient upon hearing the kind of vague message that I got?

Or maybe there should be a law to the effect that messages from a doctor's office such as the above should be required to end with the words "There isn't a problem, but we just want to discuss a minor issue or two with you."

I guess I'm just venting about this, but I was also wondering if some of you have had a similar experience: you got a call from your doctor's office, lab, etc., that sounded ominous, but upon follow up turned out to be really nothing to worry about.

Or am I making too much of this?

So have any of you had a similar experience, or have thoughts on getting this kind of call and the concern it might cause?
Posted 4/29/2014 3:16 PM (GMT 0)
Once you've gotten that dreaded call of "you have cancer" I don't think any call from the doctor is welcomed. However, for me, I still want to know the results. By not getting any news, I worry about the results and stress about it. While no news is good news may work for some--it doesn't work for me.

Tom
Posted 4/29/2014 3:53 PM (GMT 0)
If they don't call, I find myself wondering if the test was OK, or if maybe they just got busy and forgot to call. So, I really want to know, one way or the other. Silence is not always golden.
Posted 4/29/2014 3:57 PM (GMT 0)
Ditto - not getting the call would be a bad thing.

My experience is that the Doc calls with bad news - the nurses get to do the good news.... Nurses won't be able to answer the many questions that go along with bad news.
Posted 4/29/2014 4:01 PM (GMT 0)
I got a call from my MO's office and his nurse left me a message that said, in part: "I can't leave much information in a phone message but that number you may be worrying about is less than oh point oh one five -- that's undetectable. Just thought you'd like to know."

Calling is fine. What to leave as a message if they don't get you is the tricky part. Unfortunately, they can't just hang up if you don't answer because modern phones fink on callers who don't leave messages and you would see that your doctor tried to call and still worry.
Posted 4/29/2014 4:25 PM (GMT 0)
I solved that problem years ago. Every time I get a test I request the lab sent the results directly to me. You have to fill out a short form to give them permission. This serves a couple of purposes, it gets the information to me much faster than having it go through the doctor's office. I can see areas of concern and have prepared questions to ask the doctor instead of being blindsided by some abnormal reading while in the doctor's office. It eliminates the possibility of the doctor missing something or the office forgetting to call.
It has worked well and has eliminated about a week of anxiety wanting for a call or doctor visit.
Posted 4/29/2014 4:33 PM (GMT 0)
I get all my lab tests emailed to me and have email access to the doctor through a secure website. It helps keep the stress down and often I see the results before the doctor does.

Which reminds me, I have to get a blood test this week...
Posted 4/29/2014 4:37 PM (GMT 0)
Steve n Dallas said:

"My experience is that the Doc calls with bad news - the nurses get to do the good news."

Good insight, I hadn't thought of that.

So in the future if it's the nurse leaving the message, maybe that's implying the news is good. That may not work all the time, but it's probably a good guideline.
Posted 4/29/2014 5:21 PM (GMT 0)
It may have something to do with the privacy law, HIPPA.
Maybe they have to talk to you and not leave a message.

Bill from Florida cool
Posted 4/29/2014 5:35 PM (GMT 0)
My doctor's communication protocol is similar to what Steve said. The nurse calls with good news and doctor with bad news. I asked the doctor and he always calls with the bad news to answer any questions.
Posted 4/29/2014 6:27 PM (GMT 0)
After each annual round of miscellaneous testing I get a personal call from the doctor who goes over the results. If I am not home he simply leaves a message to call him back. I know to expect this call because he told me this was his protocol when I first became his patient. I really like the approach since if any reading is up or down a bit I can discuss it immediately with the doctor.

Jim
Posted 4/29/2014 7:41 PM (GMT 0)
Boith my GP and my Uro have "web enabled" their office records. I go online, enter my password and receive my results.

I used to get them mailed to me but this is faster - and I save a tree.

Ask about it.
Jeff
Posted 4/29/2014 7:42 PM (GMT 0)
The independent uro shop did not call me about my biopsy results. Had to get them in person at appointment.
With Cleveland Clinic, get PSA test the day before appointment with Nurse practitioner. She has PSA results in computer during annual appointment. They release test results to Mychart web account. Have not seen or heard from urologist in 18 months.
Posted 4/30/2014 12:41 AM (GMT 0)

81GyGuy said...
I had an initially somewhat concerning experience yesterday morning which turned out to be nothing. Having got back from running an errand, I saw "Missed Call" on my answering machine, so naturally I clicked to hear the message. It was from Kathleen, my regular nurse at my uro's office.

"We got the results from the urinalysis at your last appointment two weeks ago, and Doctor C----- asked me to call and discuss the results with you."

Uhhhh Ohhhhhh, I immediately thought. They wouldn't be calling me about this unless there was some kind of a problem! So I immediately called back, frankly beginning to get a little nervous. Got the receptionist, who of course had to put me on hold a couple of times, then spent time trying to figure out where Kathleen was, and whether she could even talk to me right now, dragging this whole thing out. But luckily I did get nurse Kathleen on the phone after a few minutes, and she simply said:

"Your urinalysis results came back normal, except for a slight rise in your white blood cell count, but Dr. C---- thinks it's okay, and there's no need to do anything about it unless you start having symptoms."

Well, having been waiting to exhale, I exhaled (not into the phone of course), thanked the nurse for the good news, hung up, and went about my business for the day, rather relieved of course.

So I was wrong in assuming that they wouldn't be calling me unless there was a problem. Well, there was a problem, but no where near the kind of thing that I had allowed my imagination to run away with.

My point: If a test gets an "okay" result, wouldn't it be just as well for the doctor's office not to call the patient about it, that is, "no news is good news?" And thus avoid the inevitable build up of anxiety in a patient upon hearing the kind of vague message that I got?

Or maybe there should be a law to the effect that messages from a doctor's office such as the above should be required to end with the words "There isn't a problem, but we just want to discuss a minor issue or two with you."

I guess I'm just venting about this, but I was also wondering if some of you have had a similar experience: you got a call from your doctor's office, lab, etc., that sounded ominous, but upon follow up turned out to be really nothing to worry about.

Or am I making too much of this?

So have any of you had a similar experience, or have thoughts on getting this kind of call and the concern it might cause?

As others have said, UF & Shands has a patient portal where one can retrieve the test resutls, schedule appt, send a msg etc.

I saw you have FL.edu as your email extension but that does not mean you have your PSA tested at Shands.

The other reason for wanting a call is to get copies of all reports and scans for my personal records

LupronJim

Post Edited (LupronJim) : 4/30/2014 11:23:43 AM (GMT-6)

Posted 4/30/2014 3:04 AM (GMT 0)
My uro's office calls with results from all tests. I have no clue if they are good or bad until the call.

My insurance will not allow results to come to me without passing through the requesting doc. Or better said, if I demand a copy before the doc calls me, they do not pay. Since money is tight, I follow the rules.

I complained, but was given a written decision from my state insurance commissioner that 100% supported the insurance company. If I choose that company, those are the rules. Suck up, or check out.

Legal consults say they are totally within their rights, and I have none, if they pay.
Posted 4/30/2014 3:58 PM (GMT 0)
(To LupronJim)

Jim -

Thanks for the reminder about the facilities at UF and Shands here in Gainesville. They are excellent, to be sure.

Yes, my email account (in my profile) is in the UF server, using the app Webmail 2.0

My own uro is in private practice here in Gainesville, and I have been very satisfied with him. But I don't believe his office participates in any app for making test results available to patients, either pre- or post-appointments. That might be a useful thing for me to look into, getting that option at Shands.

If we do get together for lunch when you next come to Gainesville, as we have planned, that is something I would like to ask you about, both your experience at Shands in general and the test result retrieval options that they have available there in particular, and who can access them.

Or would I have to be a regular patient there to qualify for this? We can discuss.

I have the May lunch date we discussed marked on my calendar! Hope to see you then!
Posted 4/30/2014 5:25 PM (GMT 0)
81GyGuy - yes, let's shoot for May 13.

My next one after that is not until July 15.

LupronJim
Posted 4/30/2014 5:27 PM (GMT 0)
for the sake of people with my kind of blood pressure they should always call and furthermore, do so promptly and not initiate the call with jokes about having good and bad news.
Posted 4/30/2014 6:14 PM (GMT 0)
lieutenant,
Like all of us, I hate surprises. Prior to my 6 month regime of meeting with my RO, I select a morning for a blood draw and have the results via e-mail(MyCare) in the afternoon; this provides me with minimal stress and I am well prepared for a meeting with my RO.
On April Fools day, I had my scheduled meeting with my RO, and since most of the lupron supposedly had disappated and my psa was undetectable I asked my RO if we could extend the test to a annual basis. He didn't laugh, but did inform me that I was not out of the woods and he was keeping me on a 6 month program for 5 years. After a dre and when I got home, I did some minimal research and discovered that out of the 28 men per 1,000 projected to die from PCa, 70% or 20 are projected to die after the age of 75. These are sobering figures when a man is as old as I; the recommendation to end screening at age 69 by most associations
doesn't make sense to me but I guess by then we are a thorough a-way generation.
The VA has been in the news lately and I can only wonder how many vets have died of PCa due to the lack of screening. What a conundrum!
Bill idea
Posted 5/1/2014 3:12 AM (GMT 0)
Yes.
Posted 5/1/2014 6:17 AM (GMT 0)
my PSA tests coincide with uro visits. I can call and get my results but I always wait until I see my uro. they don't ever call me with results.

ed
Posted 5/1/2014 9:49 AM (GMT 0)
Phone calls can be problematic. With all my docs, all phone calls are "by appointment only".
For example: after the blood test ordered by my GP that inlcuded my very first PSA test we arranged that I would call her office at a particualr time for her to tell me what the results were. (At which point she said come in again for a proper appointment as my PSA was too high)
Once I was being treated by a uro and later an RT doc, they said up front that they will never phone to tell me results and I couldn't phone them to ask for results. They said that experience has shown them that getting told a result is not the enmd of the stpry and that a decent face-to-face conversation shuld always occur regardless of whther the results are good or bad. However, they will also schedule phone consultations to save a trip to hospital. For example: it was arranged that a week or so after my cath came out they would call me at a specific time to check up on how I was coping.
The only phone call I had that was not at a specific pre-arranged time was the one telling me when they had arranged a date for me with the robot, and even that was more or less arranged, as they do their planning each week on the same day, so I was told that I was likely to get a call on a Wednesday afternoon in about six weeks, and that is exactly what happened.
Posted 5/1/2014 10:38 AM (GMT 0)
I would want to know that I'm getting a call no matter good or bad cause at least I'm expecting the call . If its "I'll call you only if there is a problem "then every time the phone would ring I would be worried that its the "call".

Also if he can call me with bad news it be nice to actually hear him tell me some good news .
Mike
Posted 5/1/2014 12:07 PM (GMT 0)
HIPAA does not prevent a provider from leaving results in a message at a number. But, the provider should only do that if the patient has explicitly authorized the provider for that number. Many small office computer systems don't track or flag numbers as authorized, so the docs fall on the side of discretion.

There is a concept called Meaningful Use that requires EMRs/EHRs to not just exist but to provide specific benefits. Online interaction with patients is a big part of the current criteria, but fears of data breaches still scare the healthcare organizations.

Lucky for me, I show up an hour before my appointment, get my blood drawn, go for a run to kill time, and I get the result at my appointment.
Posted 5/1/2014 1:54 PM (GMT 0)
I now have a system with my Onc, he emails me as soon as he can (usually next day). Works for us so far. Last email was "PSA undetectable, email me if you have questions". Subject line in the email was PSA good.
Simple and no anxiety.
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