I've never done office nursing, but have some proximity to the issue.
This is a problem that has no easy solution just because of the sheer mass of paper work. Let's say a doc sees 40 patients in a day. 17 of those get labs; some are strep screens, some are CBC's or situations where there is one test per one person and relatively easily tracked. A couple of people come in for blood sugars; they're diabetics and want/need to know the result even if it is normal. a couple of preg tests [they wanna know]. Some people come in and have a chest x-ray (to track known heart/fluid problems) and a lipid profile come in. A couple of people have CBC, lipids, multi-chems, and are scheduled for a treadmill and a mammogram. In these latter cases, all of the results will come back on a different day, scattered over days, weeks or up to a month (depending on the treadmill lab or mammo's scheduling book and the patient's life schedule). It ALL comes across either the doctor or nurses desk for review. The fact is, some people need a call back and the others don't.
In my own doc's office, she notifies by exception (if it's abnormal) except for mammo's and pap smears. Since I haven't had treadmills and other testing, don't know. I'd guess some docs will bring you back to discuss those tests. I got a phone message telling me to continue my low fat diet, re my lipids once. Other times, I've heard nothing.
To say ALL labs, xray's, other tests need to be phoned back to the client is to create a huge burden that may be unnecessary. The fact is that sorting through the masses of data that passes over a FP's or IM's desk on a daily basis in a busy practice is a HUGE paperwork task that _must be done_. I think saying, "Everything get's return notified" potentially creates an undoable care burden that results in nurses and doctor spending lots of time caring for paper and not people.
Frequent this and other boards and you will see that this is a common complaint: "I take care of paper, not people."
I'm not denying the tragedy of critical labs that don't get notified and I'm not excusing. I want you to have a little insight into how big of a job this can be in an average practice.
Patients can and should:
*View themselves as partners in the care process. Make it easy for the nurse/notifier to find you. That means correct phone numbers, addresses, work numbers.
*If you don't hear back and are curious call them. If your aunt Selma and your mom had breast cancer and you haven't heard back from your results in a week or ten days, call back.
*Know at the end of the visit, what the notification plan is. Will they call if problems, notify you by letter, expect you to call in? If the plan doesn't come off as expected or if they don't call as promised, or there is no plan to call you be your own advocate and call in for lab/test results.
*If the lump or the problem or symptom gets worse, go back. You live in your body and you are the only person that will know this info. You may feel silly or sheepish or whatever, but go back. Maybe the doctor said, I think this is viral, but we'll do a strep screen and you'll hear from us if it's positive. You don't hear from them, but things are getting worse. Go back. Maybe you had an unreported positive, maybe you had a false negative, maybe you've evolved a new problem. Go back.
*Your doctor and his/her office staff are humans. They may make mistakes. If you haven't gotten the info you want, call 'em back, reappoint, do whatever.
Now, finally. In the area of risk managment/error control, there is a movement toward making the system more of an assistant in averting errors. I suspect that the doctor's office is a little under-studied in this sense. There has been a lot in the news, for example, about how pharmacy systems can reduce error, or how the engineering of equipment in a uniform
fashion can reduce error. I suspect this is an area that would benefit from similar intervention. While I think office systems are critical in this problem, I think the patient must never underestimate their own importance in the scheme and take an active role in assuring their own involvement in their own care.