Ethical consultation

The commentary “Ethical consultations” (Can Fam Physician 2007;53:206–7 [Eng], 212–3 [Fr]), reminded me of a distressing personal experience my wife and I had last year. I write to initiate a change in the handling of investigative procedure reporting on patients. Reports on all tests, biopsies, imaging, and investigative procedures should be sent directly to the patient as well as the family physician by the analyzing facility. The recently touted electronic patient record is no guarantee to the patient of timely receipt of information.

It is a fact that the information contained in these reports is the property of the patient, not the doctors or the health care system. Direct reporting to the patient would avoid the inefficiencies of the system, the fractured communication between referring physician and specialist, and the habitual failure of institutions to identify the family physician as a recipient of reports on procedures ordered by a consultant.

Those results needing further assessment or action could easily be flagged for the patient so that a further appointment with the family doctor could be arranged. In fact, it is the patient who has the primary responsibility for his or her health and the collection of information on health status. Direct patient information would also avoid the need for many repeated office visits to learn of these results, eliminate the time staff spend trying to contact the patient, and avoid the circumstance in which the physician inadvertently misses the report.

To say that no notification will be made of normal results is to practise medicine as it was at the turn of the 20th century and, I believe, is totally inadequate today.

The personal experience that aroused our anger was the 6-week unavailability of the results of a tumour biopsy performed on my wife that should have been available in 4 days. We later learned that, for a fee, we could have obtained a report from the laboratory—a charge for my wife to obtain information about her own body.

My own physician estimates that he does not receive investigative reports on tests ordered by consultants about 80% of the time. My wife’s family physician did not receive the results until we demanded them from the specialist and the hospital.

I encourage the College of Family Physicians of Canada to pursue having analyzing facilities report test results directly to patients.

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