Competence in interpreting hospital test results

DIGITAL reporting has increased quick access to hospital test results. This brings undoubted patient benefits in speedier diagnosis and treatment but there are also some associated risks. Consider the following scenario.

A GP registrar in consultation with a worried elderly patient accesses the results of a CT brain scan taken at the local hospital. The doctor views the result and informs the patient that there appear to be “abnormalities”, although she admits to being “unqualified to read the report” and feels that specialist input is required to interpret the findings. She advises the patient that the practice will contact the hospital consultant by letter for more information.

Two days later the practice receives a letter of complaint from the patient. Upon leaving the practice after the consultation, the patient had suffered a panic attack on the way home. After receiving assistance from a neighbour, he was helped by his daughter to contact the hospital later that day. A consultant phoned back and reassured the patient that the result was fine and that the abnormalities reported are nothing to be concerned about.

The patient is relieved by this but remains very unhappy about the unnecessary stress that the GP registrar placed on him and wants an apology.

Better and timelier access to information about patient testing and reporting may lead a doctor, with an anxious patient in front of them, to review results which would not previously have been accessible. To do so could ease the patient’s worry – particularly in areas where discharge information and reporting to the GP practice is routinely slow.

However, in our experience at MDDUS this can sometimes prove counter-productive. In such situations, it is important to pause and consider the best course of action to ensure that you work within the limits of your competence. Of course, if you have an anxious patient or one whose condition has significantly deteriorated since they were last seen at hospital, you might judge that action is required.

In the case of specialist reports it may be more circumspect to inform the patient that you will investigate the matter and agree with them the most appropriate mechanism by which you will get back in touch, once you have further information. This would allow you to review the report and discuss it with the hospital team if you feel further advice is required.

ACTION: Consider the consequences of accessing results which may require specialist interpretation. It may be better to await specialist input, before providing specific comment on the results to the patient unless you feel the benefits of this might outweigh the risks.