Patient Notification and Follow-up of Abnormal Test Results: A Physician Survey

doi:10.1001/archinte.1996.00440030133016

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Vol. 156 No. 3, 12 FEBRUARY 1996

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Patient Notification and Follow-up of Abnormal Test Results

A Physician Survey

Emily A. Boohaker, MD; Richard E. Ward, MD, MBA; Jane E. Uman, MPH; Bruce D. McCarthy, MD, MPH

Arch Intern Med. 1996;156(3):327-331.

Abstract

Objective
To investigate physician practices in the handling of patients'test results from the time the test was ordered until the timeany required follow-up was completed.

Methods
Survey of 161 attending physicians and 101 residents in familypractice and internal medicine practicing at a large urban teachinghospital and 21 suburban primary care practices in SoutheasternMichigan. The survey included questions about physician demographics,and whether physicians have methods for ensuring that (1) theresults of all tests ordered are received, (2) all patientsare notified of results, (3) all patient notification is documented,and (4) all required follow-up is done. Physicians were alsoasked to self-rate the reliability of their methods and theimportance of various steps in the handling of patients' testresults.

Results
The response rate was 79% for both attending physicians andresidents. Approximately 17% to 32% of physicians reported havingno reliable method to make sure that the results of all testsordered are received. One third of physicians do not alwaysnotify patients of abnormal results. The most common reasonsreported for not notifying patients were that the results weretrivial and that the patient was expected to return to the clinicsoon. Residents were significantly less likely to document notifyingpatients of abnormal results (P<.001). Only 23% of physiciansreported having a reliable method for identifying patients overduefor follow-up.

Conclusions
Lack of methods to ensure that the results of tests orderedwere received, dependence on follow-up visits to inform patientsof results, and lack of documentation were relatively commonamong physicians surveyed. These could lead to an increasedrisk of malpractice litigation and suboptimal patient care.

(Arch Intern Med. 1996;156:327-331)

Author Affiliations

From the Division of General Internal Medicine, Department of Medicine, Henry Ford Hospital (Drs Boohaker and McCarthy), and the Center for Clinical Effectiveness (Drs Ward and McCarthy), and the Division of Biostatistics and Epidemiology (Ms Uman), Detroit, Mich. Dr Boohaker is now with the Georgetown University Medical Center, Washington, DC.

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