Shouldn't be the norm.

I'd be on the phone to the office manager of BOTH offices. There should be a procedure in place if results aren't returned promptly to the Dr's office.

Hoping the delay doesn't stress you too much!

Yea, that shouldn't have happened. Someone dropped the ball.

Unfortunately, patients have to be their own advocates these days. I've had to follow up on lab reports more than once.

I have never heard of

that happening. Should have been automatically sent to the Dr who ordered

it. Can't imagine the Dr not "taking it up" with the lab immediately. It's his

good name that goes down the tubes.

I always ask that the lab to send me a report too.

Of course it's not the norm. Someone screwed up

Agree, definitely not the norm. The doctor's office that ordered the test(s) should follow up. It may be time to change doctors.

It shouldn't be the norm, but it's almost if you want something done, you have to do it yourself. Co-worker was literally on 2 phones, one line someone who was supposed to send something to the person on the other line and on the other line the office that was supposed to received...it's like she had to orchestrate it herself. "Oh, we sent it"....check with the receiving office "we never received it"...what really happened...?? who knows.

This happened with my sister as well. She had heart problems and was monitored but the results were not sent to her doctor. When he finally did get them (much later) he was so alarmed he had her in for surgery for a pacemaker the next day!!! She didn't know and why would she that the information was not relayed. It's so scary that this is happening.

I would have to follow up with phone calls as well as strongly worded letters of conplaint.

This also happened with my BIL - he wound up in really bad shape and passed away - a very important report never got to the doctor about his blood levels until my sister started questioning things, he was a heart and diabetes patient.

I realize that things are missed or mistakes happen but what steams me more than that is the lying and covering up that happens. I went through this crud when I was trying to get the insurance authorization now that I think about it on this specialist visit, never have been able to determine who was lying about dropping the ball, the specialist or the PCP.

Yes it looks like another doctor is in the future but that's difficult in this area - this is a place where people move to die - this sounds harsh but it's true. Central Florida, very rural and behind the times where I live and the next-door community is all retirees from up North who are on Medicare. Patients are put through the gates like cattle to slaughter, just get 'em in and get 'em out and collect the Govt. subsidy. The staff are under-payed and overworked and probably not trained well to boot. Yes this is where I chose to live but back when we moved here this wasn't such an issue.

Are you close to any medical school practice groups? I drive past a lot of doctors' offices and hospitals to go to one where all services and specialties are available. My wife and I both have ready access to top drawer practitioners in an environment where caring attention to patients seems to be the standard. It costs no more, just a little bit of driving time.

I had a few incidents some years ago with so-called "small town" practitioners who extended their efforts beyond their areas of competence. Fortunately the problems were identified and resolved by other docs when I got second opinions. I learned from the experiences. This in an area that's not a small town and where there are national experts at two top tier medical schools to choose from. All that's needed is some driving time.

That varies by medical school, as well, Elmer. "Seems to be the standard" is the key. I have seen less than stellar attention and care from attendings at the two teaching hospitals where I have worked.

Both the MD's offices and the diagnostic lab dropped the ball. The electronic records system needs a mechanism to track outstanding ordered tests - or the office should keep a manual list. Everyone is suffering from the paperwork burden these days, and the patients are the ones who experience the fallout.

raee, what kind of "teaching hospital"? Many of those are nothing more than community hospitals that take residents (because they're a cheap source of labor that Medicare subsidizes the cost of).

A "teaching hospital" isn't the equivalent of a med school group practice staffed by faculty as the attendings.

Tampa General and USF are in cahoots but that's a 50-mile drive from here.

We experience this all the time and it is staff not doing their job. Multiple medical centers and doctors offices and who gets to do the prompting, calling, squeezing, cajoling? Why the person who is paying for it all. It gets tiresome but what to do?

Well, I called the imaging center this afternoon, they say they faxed that over to the Dr. on August 25th. Yet the Dr. staff is saying they never got it until they requested it yesterday. I had this same back and forth initially with this Dr. when I was waiting on authorization from the insurance and they kept saying that my PCP hadn't done their job and my PCP said they had done their job and it was in the specialist's hands. I still don't know who was the liar on that one.

On top of that, I was hoping all was well but it's not, there was a second ultrasound recommended by the diagnostician who did the report at the imaging center due to some "areas". So there actually was a problem that never would have been addressed if I had gone on and not gotten a bad feeling about this and did a follow-up call.

I am so steamed because as I said mistakes happen but I hate it when there is a cover-up. I asked the imaging center what the procedure would be if I decided not to return to this Dr. and they said they would still have to send the report to them but I could choose to go to a different Dr. and get another copy for the new doctor. In the meantime the pickings are very lean on other specialists around here that take my insurance. So now I'm in waiting mode for the PCP to get the request from this specialist to get the authorization and blah blah blah.... BTW I don't blame anyone here to skim through this and say "who cares!!" but it relieves some of my angst.

I'm SO sorry this has happened to you, Rita. A couple of years ago, my gastroenterologist order two tests and I had them done. I had an app't to see him 2 weeks later to get the results, and my DD took off work to come with me. We got there and he only discovered he had never received the test results when he looked at my file on the exam room door before coming in. He immediately called the lab and asked about the test results (it was in the hospital connected to this ambulatory outpatient clinic). They said they could "read" the one test that afternoon and send him the results, but the other they could not even find (I had worn a monitor for 24 hrs and the returned it to the lab). Total waste of my time, the doctor's and especially my daughter's.

Finally got the results of the first test 10 days later (Thanksgiving got in the middle of this). The other test was finally found and the results sent another 10 days later. Totally inexcusable and I'm sure the fault was the techs - she was a total flake.

I just saw my pulmonologist this afternoon. He's at a teaching hospital and only sees patients 1/2 day each week. And oh my, what patients they are! He was complimenting me on my self-discipline and I laughed and said that was NOT one of my shining features! He said that compared to all his other patients, I was a star. I actually TOOK my meds, did my breathing treatments, went to pulmonary rehab, watched my weight and what I eat (GERD - affects my pulmonary problem), and kept my doctor's appointment. I was stunned! Really, the ONLY one? Yes, most say they don't like putting "poison" in their bodies so take their meds infrequently, find doing breathing treatments while watching TV a problem (and are not about to give up 20-30 minutes of TV each day), don't feel well enough to get out of bed and go to rehab or their doctor's appointments.

And to think that we think the problems with medicine today is the fault of insurance companies etc. It's patients who are too dumb/stubborn to follow the advice given them by their doctors. Did I mention that most of his patients weigh in at about 350-400 pounds and complain loudly about their shortness of breath. Heck, they'd be short of breath hauling all that weight around even if they didn't have pulmonary problems! I'm 25 pounds heavier than I'd like to be and with my shortness of breath, it's very difficult - impossible - to exercise vigorously enough to lose that weight. I'm already eating very few calories - not healthy to go on 1000 calorie a day diet at age 76. Or to fast.

Some years ago a friend's friend didn't follow up on her melanoma test, the results were lost somewhere and she died of same. Can't imagine not following up on test results. Another good thing about Kaiser, as it's departments are all under one umbrella.

"Who cares?"

Indeed!

How often might it be that such inefficiency/slothfulness might result in long-term illness ... or disability ...

... or early death?

Looks like some medically-related people (sort of like dogs in training?) need to be kept on a (somewhat short?) leash ...

..lest they cause discomfort, injury ... or, even, ... death?

ole joyful ... who's thankful to be enjoying reasonably good health

Anglo talk to your doctor about that 1000 calorie food intake. As strange as it seems you may need to increase your calorie intake to loose weight. Some people's bodies think they are in starvation mode and will hold onto every calorie they can. Even worse is the calories can be translated to fat. That puffy type of fat that used to be called malnutrition fat. Your weight may be the same but your body keeps increasing in size.

My guess would be that yes, the report was faxed and the reason the clinic “didn’t receive it” is because it’s in one of the huge stacks of filing that no one has time to file or scan into records. The volume of paperwork and reports faxed to anyone clinic in a days time is kind of mind boggling. EMR programs help to cut down some of the filing because reports and lab work can be faxed directly into the patients record or sent to the doctor, but that’s only a small percentage of what gets faxed. If the clinic hasn’t upgraded to EMR yet, then yes, a lot of important information can and does get overlooked.

I service around 30 clinics and IMO it’s not that the staff isn’t doing their jobs, it’s that the clinics are not staffed at a level that enables them to keep up. If we’re going to blame anyone, it should be the hospital administration responsible for staffing of the clinics.

ETA: What is really telling is that the majority of privately owned clinics that I go to are just as busy as the hospital owned clinics, but they are staffed at a level that allows them to keep their filing under control.

Better to not use an acronym you haven't defined and others haven't used - as with EMR. I know what you're referring to but you shouldn't assume everyone does.

Lone wolf/small partnership medical practices have gotten quite rare in my area. Most have chosen to affiliate with larger practice groups, if for no other reason than to offload practice admin and management. I left a GP I was otherwise very fond of because his admin staff were a disaster that adversely affected the care he provided. I complained repeatedly until I'd had enough. I told him I would be leaving and why. He retired about a year later, I think he found the modern times of medical practice overwhelming and he didn't have the energy or inclination to deal with changes.

Electronic charts/records have become pretty standard. Medicare reimbursements are reduced for docs who don't use them.

My "medical world" seems to be entirely electronic. Prescriptions are transmitted electronically. Lab results are provided to my primary care physician (and to me) electronically. Same for test results. I had a MRI from a facility unaffiliated with the medical school system I primarily use and the test results and radiologist interpretation were provided to my doc (and to me) electronically. Faxes don't seem to be used much in my area and I'll presume there's little or no "filing" to do.

Yes, your scenario is the norm now Elmer and yes there are fines for drs who don’t use EMR, however, the small clinic EMR programs are expensive and not real ideal because they don’t interact with the larger hospital systems. The offices that I’ve conversed with about it say they’d just prefer to staff as needed and pay the fines, especially because the majority of those physicians are nearing retirement; they figure why bother.

Don’t assume that just because you don’t see faxes, that they aren’t in use. A large amount of the insurance issues like audits, workers comp, disability, referrals, physician health assessments and so on are all done via fax. 90% of the paperwork and record information I see is done via fax, even at the hospitals.

Oly, and I think about elders without support too. When you are not feeling well, it's doubly hard or nearly impossible to battle bureaucracies passing the buck. It's an unconscionable state of affaires for people working in such positions to treat their work as though it were a factory floor.

Fair enough, lukki, I don't spend any time behind the admin counters in small practices. I have observed, though, from the older docs I know and have spoken to that far too many of them are very reluctant to change their ways unless there's a major cost penalty of not doing so. When they do so, it's often grudgingly and without a true effort. As with most IT implementations in most areas of human activity, efficiencies and new capabilities should result from the upfront investment but most don't see that or want to do it. Younger docs I know and have spoken with on the subject have the opposite attitude, they think of paper records as archaic and I believe all trained these days are in medical settings where electronic records are exclusively the norm.

You probably are very aware that the medical profession lagged most other industries and professions in adopting IT processes. So the attitude of doing so kicking and screaming has been far too common in the past decade-plus as the transitions have been made in small practices.

I was told by the Medical Asst. at this office that they have EMR links with certain labs but not with others, including this particular imaging center.

rita, I have a couple of docs I drive about 50 miles to a more distant medical school to see when necessary. I recommended the same place for my neighbor (himself a physician with an unusual condition) and he was very satisfied with the result. It's more than worth it. You need to decide for yourself

Errors, oversights, something not followed up on, other problems? It depends who it is. I had some plumbing work done last week - the guy said he was pressed for time (he'd squeezed me in as a favor) and hadn't tightened a fitting enough. There was a leak, I had to turn off the local water valve, he fixed it the next day. It wasn't the main so it was okay and I detected the problem quickly. That wasn't a problem for me, I could have made the same mistake in haste.

If a doctor makes a mistake with me, I may not know it, may not catch it in time, the consequence could be very serious for me. I have zero tolerance for that. I want the best available, especially when there's no cost difference. The medical school that is my primary go-to group practice isn't too far away but for most things the available capabilities and the culture of patient care and consideration are outstanding. The more distant one is great too. I kick myself for the few decades I used other providers.

Elmer, I was referring to a very well known, university hospital. Blanket assumptions that all care at such hospitals and (especially) those well known for research is the very best, are not always correct. Some may have divisions and areas that are outstanding while other divisions may be far from it.

In San Diego I worked at a well known non-teaching hospital, where most of the attendings in my division had come from top tier institutions such as Stanford, and the attention and care from those attendings I would still call the best I have seen. It is the culture that makes the difference - as you mentioned earlier.

"Some may have divisions and areas that are outstanding while other divisions may be far from it."

I agree, this has been my experience too. I feel fortunate to have two different med school systems to choose from and try to cherry pick which I go to, for what, because each has its own different strengths and weaknesses. Folks living in or near urban centers will often also have more than one to choose from.

For San Diego, I myself would probably gravitate toward UC rather than Scripps. Scripps may fit the profile you describe as being stronger in its few focused research fields than in clinical medicine. UC probably has broader strengths but I haven't personally been to either. Friends we have in the area seem to be split between the two.

I don't know what EMR means; thanks Elmer for pointing that out, but still no one has defined it. My guess is Emergency Medical Room/Records.

I went to my dermatologist last month for my six-month check-up, and he took six samples from me. He then told me that if everything came back negative, I would receive no notification. He goes by the philosophy "No news is good news," but I go by the philosophy that "No news is ignorance." I want to be told if nothing is wrong. As it turned out, one test did come back positive for melanoma, which he removed last week, and two more were positive to Mohs. I am able to look up Test Results in myUCLAhealth.com, but none of the dermatology tests were recorded there. Most other tests are recorded there, including a cardiac stress test and X-rays, but I do not think everything gets recorded there, especially not the dermatology test results. I think I will talk to my dermatologist about this when I go back on Tuesday for more surgery. I want to know why my results are not posted on the portal. My dermatologist also came from Stanford.

Electronic medical records.

Sorry Lars, I talked about the subject with words and without referring to the acronym. I dislike acronyms of all kinds. To me, they're like other kinds of buzz words and jargon exclusive to a particular field or endeavor, too often used by some to address and define those who are insiders as distinct from those who are outsiders.

I guess then that my medical groups uses those, since I can access my records via their portal. However, the records I can access seem to be incomplete. I think that my dermatologist's office is perhaps overworked but it is definitely not understaffed, as there are plenty of people at the front office receiving patients and scheduling appointments. They may not be able to update medical records, however. The doctor did mention the word "melanoma" in my medical history, but he did not even put the year that it was diagnosed. He also mentioned "Basal Cell Carcinoma" but without dates. Since he sent out samples to by analyzed by a lab, I would think that the lab results should be in my medical records, just as my blood test results are. I am not sure that I will be able to change the office policy about this, however.

I went for the second ultrasound today. I also FINALLY was able to reach someone at the Doctors office to give me access to the patient portal but - woe is me - the lab previous lab results were not there. So I called and went through the same ol' robot messaging deal and left a message, no return call. Called again in the afternoon and finally dialed the number for appointments and actually got a person. She didn't have an explanation as to why they weren't there. So minutes before I had to leave for the 2nd ultrasound she was able to put the first test results on my portal for me to access. She was very nice and couldn't understand why there were all these problems but that's the story with all the employees there, they are all nice, seem to want to help, but are clueless and after hanging up I'm completely forgotten.

I have a couple of doctors who do the "no news is good news" results, which I don't like. It's far too easy to assume all is well when there could have been a multitude of mistakes made.

I am going to go to the local UC school for a 2nd opinion on my thyroid issues. I am seeing a local specialist now and I like him fine but he is a bit too laid back for me to feel completely confident.

Lars, I apologize, EMR = Electronic Medical Records, to say it’s full name is a mouthful and so it’s never used. If the labs you have done are just the standard used for a well check or annual physical, I wouldn’t be as concerned about getting the results and would follow up to get a copy the next time I was there, however, when the order has come from a specialist, that’s a different story. When I read your post it made me recall the first time I stepped into the office of a specific doctor to look for a file and it literally looked like the room of a hoarder. The girls up front had warned me that I wouldn’t be able to find it in there, but I had no idea how right they were.

Thanks, Lukki!

My tests were ordered by a specialist, and I wanted to know whether I was okay or not. Since I was not okay, I was notified, but if I had received no notification, I would feel like I was left in the dark and would not know whether I was okay or if the results had just been lost. I think it is always good to hear when the news is good, rather than to assume that not hearing anything is really any kind of news or not.

you’re welcome and right to expect that.

"when the order has come from a specialist, that’s a different story."

That has not been my experience at all. A report to an electronic system is a report, without regard to who ordered it or why. Just as the most recent example, I had two special tests ordered "by a specialist" last month and the results went into my regular accessible record, along with the doc's comments, when the analyses were concluded.

Last week, I had occasion to see a doc in an area away from where I live. I went to a large group practice. They were able to access my home area medical records, including lab histories, prescriptions, and doc visits, and use these to address my specific complaint. I thought that was really cool and most useful, though I'd printed some of it out and had it with me. The lab reports at this new practice I'd never been to before were similarly available to me when completed through their patient portal.

You'd think from these comments I'm either a hypochondriac or in poor health. Neither is the case, I've just had a couple of one-off situations recently. All is well, back to running marathons and climbing Mt Everest (just kidding).

Elmer, your response is about something entirely different. My comment was not about how a record is received, but by whom.

EMR programs have their many benefits and patient portals is one of them.

I still can't see lab or diagnostic reports on either my PCP patient portal or my specialist. The PCP has been like that for years. I keep complaining to no result.

Its not the norm. Someone is not doing their job. Maybe they lost or fouled up the results and are afraid to admit it. Whatever the case, its sloppy work that should be reported.

"Elmer, your response is about something entirely different. My comment was not about how a record is received, but by whom."

One of us is misunderstanding the other. I said I went to a specialist (a specialty obtained by doing a fellowship after compound residencies). He ordered some tests, the test results came back. I got an email from the lab with a link to see the test result, and I got an email same day from the patient portal saying the same thing. Where I also found the specialist's comments and impressions and final diagnosis.

Did I misunderstand you or is it vice versa?

You were misunderstanding in that the comment was in response to Lars earlier post about not hearing back if the labs were good. IMO, when physicians do that it’s a disservice to their patient most especially if the tests were ordered by a specialist.

I had my own medical annoyance today. I had a scheduled thyroid uptake scan, where I take an iodine pill and have imaging done 6 hours and 24 hours later. In the process of scheduling a month ago, I spoke with 3 different people, all who told me the only instructions were to not eat or drink for 2 hours prior to the pill.

I get there this morning and the technician asks if I have been on the low-iodine diet. I said no, that no one had instructed me to do that. She sighed and said that the schedulers were supposed to do that, and then she excused herself. I heard her talking to someone about it and asking if I need to reschedule. I was hoping not as my anxiety has been sky-high waiting for a diagnosis. Luckily they let me do it but now I'm worried the results won't be as clear. So frustrating!

It isn't what you said but we can drop it. You emphasized there was something different about seeing "a specialist". Why would "who receives it" have anything to do with the patient getting a followup communication from the physician who requested whatever test or analysis was performed?

Answer - it doesn't.

I take my dog to a GP vet. I also take my dog to a "specialist" vet. Both order lab work of different kinds from time to time and both call me AND send me the results when they receive it from the lab. Even vets do it, medical docs are no different. Lars' doc was lax, it had nothing to do with what kind he/she is.

Elmer, you have a very black and white way of reading and never seem to “get it”. The fact that others do, should make YOU realize it could just be YOU and the way you interpret things.

Nice try but you said what you said and trying to prevaricate or act as if it were equivocal doesn't change it. I've asked you to explain if I misunderstood but I don't think you can. Not the first time you've tried to back away from something you said. The insult also a fail and also not the first time.