CENTER FOR THE ADVANCEMENT OF HEALTH SEPTEMBER 2008 Test Anxiety Printable Version GoodBehavior! archives Have you ever spent the weekend awaiting results of a medical test -- to confirm a cancer diagnosis, for example -- after the doctor failed to call Thursday as promised and didn’t return your calls on Friday? Gives new meaning to the idea of “the endless weekend.” When I ask people about their health care, one topic that comes up repeatedly is when and how they receive the results of medical tests. The situation described above is too common. But so are lost results, dangerous conditions that were detected but never reported to patients and general bewilderment about what the test results actually mean. A fiery argument about patient notification of medical test results recently raged on the New York Times “Well” blog. Most doctors discussed the logistical difficulties of keeping track of and communicating with all their patients about all their test results. Some doctors and some patients took the middle ground – “If you don’t hear from the doctor, call and inquire.” Outraged patients’ responses ranged from “I don’t know what these results mean – the doctor should call me to explain” to stories of recalcitrant providers whose non-responsiveness resulted in the patient firing his doctor or injury or both. Jessie Gruman President Center for the Advancement of Health The number of tests results successfully reported to patients undoubtedly dwarfs the frequency of erroneous, misplaced or unread findings. But this whole business of learning test results illustrates our larger struggle to find the right balance of responsibility with those who care for us. Being a passive patient is no longer an option. But the transition to more active participation in our care means that we need guidance about how to play our new role effectively. How are we supposed to know the process a specific doctor or clinic uses to report results to patients unless we are told? How can we tell if it has happened and what we should do if it doesn’t? Guess? I would welcome a piece of paper that says the following: “This is how we handle tests here: We expect to receive the results within 5 days. We will notify you within 3 days of their receipt by (select one) a) e-mail b) telephone – direct contact c) telephone voicemail We will give you information about whether and how to follow up with the doctor at this time. We will send you a copy of the test report within a week of receipt of the results including a brief explanation of the purpose of the test and the meaning of the results. If you have questions, need to expedite this process or if you do not hear from us by X date, please call Patricia at this number.” While this piece of paper won’t ensure accurate testing, competent interpretation or a clear course of action based on my test results, it does tell me some of the steps I need to take to be a competent participant in my own care. This is a small piece of health care delivery but it illustrates a critical point. Knowing (1) what is supposed to happen, (2) who is accountable for it and (3) what our responsibility is in ensuring that it happens is a basic requirement for each of us if we are to benefit from the health care that is available to us. __________ Resource: New York Times, Well Blog: http://well.blogs.nytimes.com/2008/08/21/why-you-should-call-your-doctor-for-test-results/ FROM THE HEALTH BEHAVIOR NEWS SERVICE The Health Behavior News Service regularly distributes stories summarizing new research on health behavior issues. These stories can be found online at http://www.cfah.org/hbns/current.cfm. Here are some stories released in August:   Nebraska Women Benefit From Efforts to Close Gaps in Cancer Screening A decade-long Nebraska study that showed disparities in breast and cervical cancer screenings may have spurred changes that raised the percentage of women screened in the state. The researchers found that Native American women were more likely than white women to have mammograms ordered, while African-American and Native-American women were less likely than white women to have a clinical breast exam. African-American women were less likely than white women to have a Pap test Sexual Matters Don’t Sway Mothers on HPV Vaccine The opinions of women about sexual matters do not play a significant role in their decisions about whether girls in their care should receive a vaccine against a sexually transmitted virus, according to a new survey.  The findings counteract assumptions that some mothers refuse to let their daughters be receive the HPV vaccination because they oppose sex before marriage. Home Smoking Bans Prevent Teens From Lighting Up Parents who enforce no-smoking rules at home are less likely to have teens who experiment with cigarettes, a new study finds. Youths who lived with nonsmokers but didn’t have a household smoking ban were nearly twice as likely to try cigarettes, compared to teens whose parents banned smoking. Reducing Risky Health Behaviors in Teens: A Tall Order A new study by Canadian researchers finds that programs targeting at-risk kids must tackle a constellation of issues in order to be effective. “To really improve adolescent health, programs should seek to reduce risk taking, improve social capital and improve levels of affluence,” a study co-author said, although he acknowledged that this is a tall order. Family Planning Clinics Save Public Money, Study Finds Publicly funded clinics that provide women with reproductive health care save government money, a recent analysis concludes. For every $1 the government spends providing family planning, $4 is saved, found researchers who estimated a net public savings of $4.3 billion in 2004..