1. Harpham, Wendy S. MD, FACP

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Dear Patient,


How you learn your test results matters. The fastest way is usually through the patient portal-a secure password-protected internet site where you can see most of your medical chart. Because results are posted automatically, you may be able to see results long before your physicians have an opportunity to contact you. This handout discusses potential benefits and risks of learning your test results online. You'll find tips for managing your expectations and minimizing stress.


Why don't physicians call right away with test results?

Abnormal test results may create a sense of urgency, even if medically it is completely safe to wait a few days or weeks to address them. We wish we could call you the minute your test results are available, but that's not realistic.


In an imaginary world where you are our only patient, you still might have to wait to hear if after we see your report we need to:


* Review your chart's notes and compare the results with previous test results.


* Discuss the results with the physicians who performed or interpreted the test.


* Connect with colleagues to discuss your case.


* Check the latest medical articles related to the test findings.



Here's the practical dilemma: Throughout the day, dozens of test results from many patients are posted online. Meanwhile, some patients (in the hospital or clinic, or at home) develop medical problems requiring immediate attention


We are deeply committed to every one of our patients. As much as we don't like to, we must interrupt visits with patients when other patients have emergencies-as we would do for you in a medical crisis. Despite our striving to work efficiently, days may pass before we have an opportunity to discuss your test results with you without interruption.


Do you have to check your results online?

No. We want you to do what's best for you. We welcome your using the patient portal but don't want you to feel obligated. Just because you can does not mean you must or should. If you prefer to learn test results directly from your physicians, consider (1) stopping text alerts for test-result postings and (2) scheduling tests closer to doctor visits. Note: If tests are performed right before a visit, the results may not be available in time, or your physicians may not have had a chance to review them.


How might you benefit from learning test results from your portal?

When test results are clearly good news, patients don't worry about frightening outcomes that have been ruled out. When patients understand correctly that the results show serious problems, some people appreciate the chance to react emotionally in the privacy of their home and to slowly absorb the news before discussing the results with their physicians.


What problems might arise after accessing results online?

It's one thing to hear news from your physician who explains the findings and discusses a plan of action. It's quite another to learn news from a technical report intended for physicians and written by someone who doesn't know you. Potential risks of accessing results online include:


* Learning of a frightening diagnosis presented in cold, medical terms and without an explanation or plan of action.


* Misinterpreting results as "bad" when, in fact, the findings are "good"-or at least better than you think.


* Concluding all is well and then feeling shocked when you learn the results indicate problems. Or, worse, concluding it's safe to delay or cancel a scheduled follow-up visit that you need to keep.


* Making unwise decisions about work or home based on thinking your situation is worse or better than it is.


* Losing self-confidence if normal test results lead you to believe symptoms are "in your head" when they are physical and need further evaluation.


* Sensing an increased loss of control if unsure whether to feel relieved or worried.


* Feeling annoyed, angry, helpless, or neglected because your doctor's office has not yet contacted you about abnormal results.



What if the report indicates a problem needing immediate medical attention?

Testing centers notify doctors about test results requiring urgent medical attention. Patients are not responsible for notifying physicians. That said, if you don't hear from the office after a report indicates "immediate attention required," you can call: "I saw the report. Please advise me what to do."


How can you manage any anxiety while waiting to talk with your physicians?

Whatever your medical background, problems may arise from seeing your results in a format and language healthcare professionals use to communicate efficiently among themselves. Remind yourself: We screen your results as they come in; your physicians are doing the work needed to draw conclusions about what the findings mean for you; and we will contact you as soon as possible. Some calming mantras for self-talk include:


* The purpose of test reports is to help my physicians care for me-and not to provide information to me.


* The final assessment in a report is a conclusion about the test result-and not a conclusion about my situation.


* I cannot know for sure what test results mean for me until I discuss them with my physicians.



What if test results cause you distress?

Disappointment, fear, and sadness are common, normal, and logical reactions to test results that are not what you'd hoped for, especially if they suggest new or worsening cancer or other disease. As explained above, it's best to not draw conclusions until your physicians explain what your results mean for you. Please, don't make the mistake of using the internet to explain what the results mean for you. And please, let the office know if you feel distressed while waiting to review results. We will do all we can to help.


What now?

You get to choose whether to access your results online. What works best for you may change as your situation changes. Let us know how we can assist you in finding an approach to online test results that helps you get good care and helps you live as fully as possible today.


WENDY S. HARPHAM, MD, FACP, is an internist, cancer survivor, and author. Her books include Healing Hope-Through and Beyond Cancer, as well as Diagnosis Cancer, After Cancer, When a Parent Has Cancer, and Only 10 Seconds to Care: help and hope for Busy Clinicians. She lectures on "Healthy Survivorship" and "healing hope." As she notes on her website ( and her blog (, her mission is to help others through the synergy of science and caring.

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