Having a Medical Test? Ask Questions and Don't Forget to Get the Results

Numerous mistakes are made all along the way once the primary care doctor orders a test, according to a new survey of eight family medicine practices. The wrong test is ordered; the test is incorrectly administered; incomplete results are conveyed to the doctor; and the results are not reported to the patient. These are a few of the errors reported in this survey that allowed 243 doctors and their staff to report their experiences anonymously. The research team, led by J. Hickner of the University of Chicago Pritzker School of Medicine, set out to learn the most common testing errors and how often they harm patients There was no attempt to determine the total incidence of testing errors.

The findings were published in the journal Quality and Safety in Health Care. Either not ordering a test or ordering the wrong test accounted for nearly 13% of the errors reported in the survey. In about 18% of the reported errors, the correct test was ordered but not administered properly. The most common type of error (25%) involved delays in getting results from the lab, especially in practices that use a high number of different labs and in practices that have poor follow-up systems.

Patients were unharmed by 54% of errors, but 18% did result in harm. Worse, "harm status" was unknown for 28%.

"Minority patients were more likely than white, non-Hispanic patients to suffer adverse consequences or harm," wrote Hickner and colleagues.

Bottom Line: Always ask what the test is for and its estimated rate of accuracy. Don't assume that "no news is good news." Always call for an explanation of your test results. Better yet, request a copy for your files.

Maryann Napoli, Center for Medical Consumers (c) 2008

Copyright Center for Medical Consumers Sep 2008

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