Requesting Test Results

Some places make it easier than others to get copies of your test results (and other medical records).

At my PCP’s office, the first time my doctor went over lab results in detail, he offered, “Would you like a copy of this?”  At the end of the appointment he handed that page to the MA and asked her to make a copy for me.  Another time my husband had some abnormal labs and the nurse who phoned offered to mail him a copy of the results.

My PCP makes it easy – it’s the culture in his office.  When I wanted more information and asked the front desk how to get copies, the receptionist grabbed my chart and said, “I can make copies for you right now.  What do you need?”  That’s for just one or two sheets of paper.  When I asked for a whole bunch of copies, I was asked to sign a release.  My doctor keeps track of stuff like that.

I appreciate his approach a LOT because it hasn’t always been so easy.

When we moved, finding a new pediatrician for my kids was difficult.  The first doctor didn’t work out.  When we left that practice, it was nearly impossible to get my kids’ records.  First I phoned and asked, but nothing happened.  Next I completed the records request form for the new doctor and his office sent it to the old doc.  Nothing happened.  I phoned again and was told that I’d have to fill out the old doc’s records release form.  Okay… Still nothing.  I phoned one last time to receive more empty promises.

Finally I wrote a letter citing specific dates that I’d previously asked for my kids’ records and closed with, “It isn’t supposed to be this hard!  What steps do I need to take to have you release these records that my children’s pediatrician has requested and I have a legal right to obtain?”  This was misconstrued as a threat of legal action, and the records were copied and sent to the new pediatrician promptly.


According to the Health Insurance Portability and Accountability Act (HIPAA), patients in the United States are legally entitled to see their medical records.  Patients are also entitled to copies of that record, including test results.  This is not either/or.  We’re allowed both a peek at the chart, and a copy.

The doctor doesn’t have to give the copies away, though.  It takes time to pull a chart, find the requested pages, make copies, then re-assemble the chart.  Paper and ink for the copy machine cost money.  Postage adds up.  Doctors are allowed to charge a fee to cover the costs associated with getting copies for patients.  One of my first jobs involved quite a bit of filing (which led to my speedy decision to attend college), so I am strongly in favor of making people pay reasonable costs associated with all this paperwork.

Just to confuse matters, in addition to HIPAA, every state has extra laws surrounding the subject of patient-access to medical records.

Confused yet?  There are some circumstances in which doctors can deny a patient’s request – for instance if the doctor believes that the patient would cause harm (to self or another) upon learning the information in question.  There are ways around that, though.  Reference the above links if you need more information.

If a simple request to your doctor doesn’t yield the desired results, check out Trisha Torrey’s How to Request Your Medical Records for some good tips.


Asking for Results

You don’t have to read very many medblogs to discover that there are doctors who prefer giving patients a general “everything looks okay” report, rather than providing a copy of all the specific test results.  Not that there’s a problem with the information, but because without training people don’t know what matters and what’s not worth worrying about.

When patients see values outside the normal range, they get worried. 

Oh, no!  I’m not normal!  I’m abnormal.  There’s something wrong!

This can lead to frantic phone calls to the doctor’s office about things that aren’t medically significant.  Quite honestly, when there are people waiting who are sick and in pain and needing help, it would drive me crazy to instead spend time on the phone reassuring healthy people that they’re okay.  I can understand why it bugs doctors.

There’s another aspect to this, though.  The doctor gets to move on to the next patient, forgetting about anything even slightly unusual until it becomes obvious whether or not there’s a problem.  As a patient, I don’t have that luxury.  I have to live in my skin.  Every day I’m a guinea pig in the better-living-through-pharmaceuticals experiment.

Sometimes patients want their lab reports. Doctors don’t necessarily want to spend their time explaining normal results.  What’s a good compromise?  I hope I’ve found one.  Instead of phoning my doctor to get results, every time blood is drawn I ask the lab to send me a copy of the report.  It doesn’t take any time or resources from the doctor, but I have my information.  Having a copy of my results lets me relax; I’m not waiting, wondering if the doctor’s office will phone to say that something else has gone wrong.

LabTestsOnline is a pretty good reference.  Anyone can look up any test to learn what it measures and what it might mean if results are high or low.  This allows me to be reassured immediately when things are normal, and provides background so that I am better able to understand my doctor’s explanation when they aren’t.

What about phone calls?  My doctor knows what’s too far outside normal to ignore and notifies me if there’s a problem.  I never call for a free explanation over the phone.  If something is concerning enough that I really need an explanation, it’s worth making an appointment to discuss.



In the news recently:

  1. Health care is expensive
  2. The government is going to take control of healthcare to keep costs down
  3. Some people will die sooner because treatment might be considered a waste of money
  4. Women should wait an extra ten years before getting screened for the second-most deadly cancer they might ever face

Who planned the timing of this announcement regarding new mammogram guidelines?  The U.S. Preventive Services Task Force could obviously use some help in their PR department!

It is with bemusement that I note all the hoopla surrounding the new mammogram guidelines.

None of my friends and acquaintances look forward to a mammogram.  I certainly don’t!  Nobody waits with eager anticipation until they are again eligible for their next squishing session.  This is something that people postpone and do as infrequently as they can get away with.  I don’t personally know anyone who is upset about the new recommendations.  It’s more of a collective sigh of relief:  Whew!  Now we have a legitimate excuse to not go for that test!

When doctors claim, “studies show…” it insinuates that laymen are too stupid to understand the meaning of raw numbers.  It harks back to the days of paternalistic medicine.  I’d love to see the facts:

# of people in observation groups
# of people not getting mammograms
# of people getting mammograms – broken into two categories:
       -routine screening
       -in response to the discovery of a lump
# of those people who do self-exams
# of those people who do not do self-exams
# of people who found lumps doing self-exams
# of people who missed lumps in spite of doing self-exams…

# of patients whose mammograms led to biopsy
# of biopsies benign
# of biopsies malignant

# of people who had serious complications from benign biopsies (harmed due to mammogram)
# of people with malignant biopsies who were cured – break this out as to how many were discovered and treated due to routine screening vs how many of those biopsies were not because of a routine screening mammogram

Are we talking about one study or twenty?  Is this data on thirty people, or five thousand?  Show me that these studies were done on large groups of women in a variety of locals, and that the data is the same regardless of race.

An approach that presents the raw data can lead people to a logical conclusion.  Instead of being paternalistic, this method clearly states the facts and implies that people are capable of making good decisions (this might not be true – people frequently make bad decisions, but PR is about perception).

It is so much easier to respond to anecdotes when the facts are readily available.  Facts don’t belittle the heart-rending stories that are circulating; showing the raw data would acknowledge that some cancers are identified by routine screening.  However, it would also make clear whether those anecdotes are typical, or if they’re anomalous.  Make it clear – using incontrovertible numbers – whether more people are helped by routine screenings, or harmed.

(fwiw, this approach would be a good idea when presenting the facts about v.a.c.c.i.n.e.s, too)

Happy Thanksgiving
So grateful to have gotten my flu shots
before getting together with family to share germs.
There are always people who show up sick because they wanted so much
not to miss out on the big get-together.