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PROS and CONS

BY DR. DAVID EDWARD MARCINKO MBA MEd CMP®

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SPONSOR: http://www.MarcinkoAssociates.com

§ DIRECT PATIENT ACCESS TO LABORATORY RESULTS

According to Patricia Salber MD [personal communication], there are a number of reasons why direct patient access to laboratory medical results is a good idea:

• Between 8 and 26% of abnormal test results, including those suspicious for cancer, are not followed up in a timely manner.  Direct access could help reduce the number of times this occurs
• Self-management, particularly of chronic illness has known benefits.  Just like the QS people, many folks with chronic illness obtain and manage to self-acquired lab results every day via gluco-meters, home pulmonary function tests, blood pressure measurements, and so forth.  Direct access to laboratory-acquired data, one could argue is a continuation of that personal responsibility
• Patients want to be notified about their results in what they perceive as a timely fashion.  In one study, patients who received direct notification of their bone density tests results were more likely to perceive they had timely notification compared to usual care even though there was no measurable effect on actual treatment received after three months
• Being more responsible for test results could encourage consumers to try to learn more about the meaning of the test results, conceivably increasing their health literacy. 

But, the arguments against direct access discussed include the following:

• Patients prefer their physicians contact them directly when they have abnormal test results, although the major studies published in 2005 and 2009, preceded the extraordinary use of the internet to access health information that exists today.
• There is concern over whether patients will know what to do when they receive the results – will they make erroneous interpretations or fail to contact their docs?  This could be, but the intent of the proposed rule is shared access to the results.  We suspect if the rule become law, docs will develop better notification mechanisms so that they reach the patient before the patient directly accesses the results or lab companies will design better lab test notifications with easy-to-understand interpretations or a whole new industry will appear that can provide instantly available individualized lab interpretation…or maybe all three of these would happen and that would be a very good thing.
• Unknown impact of dual notification (doctors and patients) of lab test results on physician behavior…would docs simply shift responsibility for initiating follow-up care from themselves to their patients?
• Would direct access of life-changing lab tests, such as HIV or malignancy, lead to unnecessary patient anxiety – or worse?  (Conversely, is there less anxiety, desperation, or suicidal ideation if the bad news is delivered face to face? 
• Individuals likely may contact their physicians immediately after getting the lab results asking for a telephonic or face-to-face interpretation … it is not known how this would impact physician workload and/or potential for reimbursement [personal communication, Richard Hudson DO, Atlanta, GA].

EDUCATION: Books

SPEAKING: Dr. Marcinko will be speaking and lecturing, signing and opining, teaching and preaching, storming and performing at many locations throughout the USA this year! His tour of witty and serious pontifications may be scheduled on a planned or ad-hoc basis; for public or private meetings and gatherings; formally, informally, or over lunch or dinner. All medical societies, financial advisory firms or Broker-Dealers are encouraged to submit a RFP for speaking engagements: CONTACT: MarcinkoAdvisors@outlook.com 

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Filed under: "Doctors Only", Drugs and Pharma, Ethics, Op-Editorials, Risk Management, Sponsors, Touring with Marcinko | Tagged: CMP, finance, insurance, Investing, investment, lab tests, laboratory results, life insurance, Marcinko, medical laboratory medical tests, medical test results, Risk Management |