Handling Unsolicited Test Results BY ERIC ZACHARIAS, MD
SCENARIO A
Since you have direct knowledge of
Pre-existing physician-patient relationships
tice would be to follow up with the patient directly and not assume some
CASE STUDY Your 47-year-old patient self-referred for a heart scan after his older brother had
6
the at-risk test result, the best prac-
other physician is following up. Although the scenario would not
a myocardial infarction. You have taken care of this patient for at least 20 years
warrant urgent evaluation, the test
and you last saw him three years ago for a routine physical exam that was
results do reveal potential risk factors
unremarkable including normal labs. He also saw a cardiologist approximately
for major adverse events such as heart
five years prior to evaluate palpitations. The heart scan results revealed an
attacks or strokes. Arranging for com-
Agatston score of over 300, placing the patient in the highest risk category for
munication with the patient regarding
coronary heart disease and future myocardial infarction. Your office received a
results and next steps, even though
fax with the results from the walk-in heart scan clinic.
you did not request the tests, ensures appropriate follow up occurs.
In this case, since there is an existing
interpretation of the test result and
You may be in a physician-patient
physician-patient relationship, you
determining the course of action,
relationship that is not necessarily
should assume responsibility for
regardless of whether the patient
obvious. For example, accepting a
contacting the patient to discuss the
self-referred for the test.
capitated payment from a health plan
meaning of the results and a plan
Additionally, you should not
on behalf of a patient may establish
of action. This could be an office
assume that the cardiologist who the
a physician-patient relationship
appointment, a telehealth visit, or a
patient saw before has either received
regardless of whether you’ve actually
phone conversation. Alternatively,
the heart scan results or is acting
seen that patient. You should be
you could refer the patient to
upon them (even if the report explic-
aware of this potential issue in your
the
itly states a copy is being sent there).
practice setting.
appropriate
specialist
for
MidwestMedicalEdition.com
