Dr. Janet Armstrong has always had a love-hate relationship with laboratory reports. Reviewing them is a chore. But she also considers them to be incredibly important to good patient care.
So, realizing their importance, Dr. Armstrong sends the actual lab reports that she receives to the patients themselves, with each report embellished with a short handwritten note that she adds.
This personal annotation serves to reassure her patients that their physician has actually paid attention to the lab results and is concerned about their care, Dr. Armstrong said.
The personal note is also a place for her to reiterate recommendations and to express concern or give praise for positive or negative changes in such measurements as glycohemoglobin or cholesterol levels.
Finally, the handwritten note encourages her patients to put together a medical file at home, which helps to engage them in their care.
Dr. Armstrong practices internal medicine as part of a four-physician family practice in rural northeastern Montana.
The practice used to send her patients a form letter filled out by a nurse, with a check mark for “normal” or “abnormal” next to the appropriate test.
But she found out just how emotionally fraught lab results can be for patients when she herself underwent a medical test.
“I remember receiving a 'normal lab notice' weeks after the test had been done,” she recalled.
She found herself “worrying in that hypochondriacal and paranoid way that maybe the actual lab got lost, and they were just telling me that I was normal because that is what I would want to hear.”
“I know I would have felt better to see an exact copy of the lab with a doctor's note on it,” Dr. Armstrong added. “I had to call just to get the notice.”
Because she realizes how much prompt return of lab results means to a worried patient, Dr. Armstrong makes a point of reviewing the reports and sending them on to the patient the same day that she gets them.
She also instructs her patients to call to remind her if they do not recieve their results soon.
Dr. Armstrong noted that she recently had a patient who was not notified about abnormal results on a CT scan because another physician, who was on leave, had been recorded as the ordering physician.
Fortunately, that patient called the practice to inquire about the missing report.
“Annotating each lab is time consuming and redundant at times, but it has served to empower my patients, given them a sense that their health care is important, and has served as a record of my concerns and recommendations for follow-up, which makes it worthwhile in my practice,” Dr. Armstrong said.
'Annotating each lab is time consuming and redundant at times, but it has served to empower my patients.' DR. ARMSTRONG