I have real difficulty with anyone discussing results with a patient
without knowing why the test was ordered and what the patient's history
is. There is no connection between releasing patient's property
(results) to them and interpreting the results for them. In Quebec the
patient has a right to their results on request and all they have to do
is to come with the appropriate ID to either Medical Records or the
laboratory, sign a consent form and they will be given any results they
require. They are never given over the phone. All Physician requests are
faxed and on the rare occassion they need to be given by phone the
physician/secretary is phoned back with the number in the LIS for that
physician. If I am directly asked by a patient for an interpretation, I
will always send them back to their ordering physician and on the very
rare occssions I have complied with the request I have always spent at
least 5 to 10 minutes talking with the patient, face to face before
offering any opinion. It is naive to think that discussing results out
of context will do more good than harm. There are far too many examples
from pregnancy tests being used as a tumour marker to iron deficiency
anaemia requiring a follow up for GI blood loss and so bowel cancer.
I personally treat all such requests with caution and would advise the
same for others. I am biased by the fact that I work on the wards as an
attending and a consultant and perhaps am so often reminded that the
obvious answer is not always correct and that patients often interpret
what we say in ways that seem to bear no resemblance to the simple facts
we are communicating. It is often more complex than it seems. It would
do well to ask why that particular patient is asking you to interpret it
and not their GP. To come between a patient and their doctor is not a
desirable place to be in.
Elizabeth Mac Namara
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