How to get through the anxious period of waiting for physical examination results

How to get through the anxious period of waiting for physical examination results

A few years ago, MaryAnn and Drew Siraj, who were in their early 30s, lived in Houston. Szilagyi and his wife had a routine checkup, so they didn't have to wait for a call from their doctor with blood test results. In just two days, Mr. Siraj, the banker, could log on to the website and peruse his medical report. He breathed a sigh of relief? Everything was fine.

But when Mrs. Siraj, a high-end kitchenware salesperson, also went online to check her own results, she found nothing. Instead, a message flashed on the screen: Contact the doctor.

The little alarm in her body immediately started clanging.

She left 4 messages for the doctor that day. No reply. The next day, Ms. Siraj, who has a family history of breast cancer, begged the receptionist for help. The receptionist pulled out her case and told her: ?I can't tell you what's wrong, but I don't think you need to worry. ?

Now, Mrs. Siraj is angry and scared, and she is still uneasy. On the third day, the doctor's nurse called? What was the result that was so mysterious that she was so entangled?

Mrs. Siraj finally discovered that she was just slightly deficient in vitamin D.

?Get more sunshine and eat something good? That’s all that makes me so stressed,? said Mrs. Siraj, 35 years old.

Every patient has experienced the anxious moment after an important examination. Doctors often turn a blind eye to patients' anxieties, deliver bad news bluntly, fail to call in time to inform them, and even lose the entire physical examination report.

With hospitals uploading cases online and state regulations loosening, many patients can quickly get diagnostic results directly from the laboratory through the Internet and apps without waiting for a call from their doctor. By the end of 2012, new federal regulations may grant this right to all patients. Many experts worry that making physical examination reports so readily available will have serious consequences: patients will become increasingly confused and overwhelmed by a large amount of information they do not understand.

According to a survey by the Centers for Disease Control and Prevention, hospitals in the United States performed approximately 6.8 billion tests in 2007, with more than 4,000 diagnostic tests available at that time. There are 1,420 cases of disease that can be discovered through genetic testing.

Studies have proven that the anxiety caused by waiting for physical examination results cannot be underestimated. The research subjects include patients who have undergone breast cancer biopsies, infertility patients and patients who have undergone genetic testing. Results show that psychological stress alone can prolong recovery times and worsen medication side effects. At the same time, it also brings a serious mental burden to the patient's family, especially for families where members deal with problems in very different ways. For example, one family member is particularly optimistic, while others tend to prepare for the worst.

An exploratory study conducted by Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, USA, was published in the spring of 2012 in the "U.S. The Journal of the American College of Radiology. The study found that more than 80% of patients said they would prefer to get results online within three days. No matter how obscure the medical terminology may be, it's better than waiting a week or more for a doctor to explain it. By the end of September 2012, patients at the medical center could read test results directly three days after the doctor signed them off, and in some cases even sooner.

Once you know what your problem is, you can start planning, says Elvira V. Lang, a radiologist who teaches at Harvard Medical School. )explain. She has studied the impact of mental stress on cortisol levels in patients awaiting biopsy results. She said that before you know the outcome, you can imagine the worst ending, but you can't plan for the next step. ?

Although some tests can be concluded in just a few hours, many high-cost tests, such as pathogen culture or tissue culture, still take days or even weeks. Dr. Hardeep Singh, who published an article in The Journal of the American Medical Association in December 2011 about direct access to test results for patients, believes that doctors are using feedback information in this way. It was not done in a timely manner.

Dr. Singer is director of the Healthcare Quality Program at the Houston Veterans Affairs Research Center of Excellence. He mentioned in an interview that many studies have found that as many as 36% of abnormal test results are delayed or not notified to patients at all by doctors, including diagnoses that suggest malignant tumors.

He said that there are many reasons for this problem, the most important one is the lack of a reliable tracking system, and a busy doctor can basically get hundreds of inspection reports a week.

Since 2003, patients have had 30-day access to their personal medical records from doctors, hospitals and health care programs. The exception is laboratories that perform most tests, and must report the results to doctors.

Currently, 7 states allow laboratories to provide results directly to patients, 7 states require a doctor’s consent, 23 states remain silent on this, and the remaining 13 states require laboratory reports only Hand it to the doctor. However, a new proposal under review could tweak federal health privacy regulations to allow all patients to request test results directly from labs, up to a 30-day limit.

Will getting results more quickly reduce anxiety? Or, without the doctor’s background introduction and professional explanation, will this move cause more serious anxiety or even false confidence in the patient?

How Dr. Jason Poston, a researcher at the Bucksbaum Institute for Clinical Excellence at the University of Chicago Medical Center, feels about the move. Mixed flavors.

For patients, they have more initiative, Dr. Poston said, but any abnormalities will be marked in red or bold letters, some are random, and some are not. It means you are seriously ill. So when the information is too little or comes too late, you will be anxious; when the information is too complicated and comes too easily, you will still be anxious because you can't cope with it. ?

Physical exams continue to grow in variety and complexity. Many test results do point to the need for important intervention. And for those results that merely hint at statistical possibilities, further testing can be done, or ambiguity can be "continued to observe." The sophisticated, complex interpretation required for such results is often far removed from what an average patient would understand when reading the report for the first time.

Many experts believe that if patients are allowed to obtain physical examination reports directly, doctors and laboratories should ensure that patients are provided with appropriate information to help them understand the numbers on the report. At the same time, doctors need to follow up immediately.

As a critical care expert, Dr. Poston asked medical students to teach patients how to understand the test results before performing the examination. He told students: Patients should have more realistic expectations about what the results can and cannot explain, and why some tests take a certain amount of time to analyze. In this way, not only is patient anxiety reduced, Dr. Poston said, the physician's role as a key leader and collaborator in patient care is also strengthened, and even the initiative to participate in major decisions based on patient needs is more supported.

Dr. Poston added: Well-informed and calm patients are also more likely to accept physical examination results, surgery and medication, thereby improving prognosis. But it takes time for doctors to care for their patients' psychological needs, and they can't charge for this thoughtful care. Dr. Poston said: How can our medical system meet the needs of patients and be profitable in the long term?

Mrs. Siraj from Houston, who was frightened by the results online, once experienced Had two troublesome pregnancies. At that time, she could not get the physical examination report directly, and all the results were carefully explained to her by a genetic expert.

Her unique experience allowed her to understand important medical information through old and new channels.

She became pregnant for the first time when she was 31 years old. During routine ultrasound and blood tests in the first three months, the screening test discovered an abnormality: the probability of the fetus having Down syndrome was 1/191. Dr. Jennifer M. Hoskovec, director of the prenatal genetic counseling program at the University of Texas Medical School in Houston, met with Mrs. Siraj. Mrs Siraj decided to have an amniocentesis, knowing it could be dangerous to the fetus.

It takes two weeks to have the surgery, and another two weeks to get the results. Mrs. Siraj was extremely nervous, had a migraine, and couldn't eat. Dr. Hoskovec intervened. She tried to allay Mrs. Siraj's concerns by providing impartial information, and she did not dismiss the anxiety as a fuss. ?Pregnancy is really stressful,? she told Mrs. Siraj. Worry and fear are normal.

Finally, Dr. Hoskovec brought good news: the baby boy in the belly was fine. The first screening was a false positive result.

However, when she was pregnant for the second time, something went wrong again during Mrs. Siraj’s three-month routine checkup. She had another amniocentesis.

Dr. Hoskovec called her and told her: In some embryonic cells, a small segment of chromosome 10 was missing. The mutation might be normal, she said, but it could also mean it's dangerous.

At 18 weeks of pregnancy, Mrs. Siraj underwent amniocentesis for the second time. ?I was worried and full of remorse,? ?she recalled. ?My husband thought the risk was low, but I didn't. Why do I feel that I am so great that I can play God and want to know what will happen in the future? What did I just do to the child in my belly?

Later, Dr. Hoskovec called Silla to tell her Mrs. Gee: She will give birth to a healthy baby girl as expected.

In Texas, where Siraj and his wife live, patients can directly obtain laboratory test results, provided they obtain the consent of their doctor. However, if the newly revised federal law takes effect in the second half of 2012, this prerequisite can be deleted.

Patients and test report providers across the United States will be faced with the question of how to deal with this new regulation. Will the responsibility for understanding test results be transferred from doctors to patients? How do doctors ensure that patients understand the reports they see online? How do doctors deal with the overwhelming number of nervous calls from patients that follow?

In theory, it goes without saying that patients should know the results as soon as possible. However, after waiting for far more information than she was willing to remember, Mrs. Siraj felt that sometimes expert explanations were more important than timely results.

?If you only did a general screening, it is good to read the report online to reduce the waiting time. ?she said.

What if she had read her second amniocentesis report online? I was absolutely devastated. ?She said:

?I need Jennifer and her knowledge and experience to help me tide over the difficulties. ?

Small preparations to deal with big situations

When patients wait for the results, anxiety gradually increases, and time becomes extremely slow. But experts say patients can take back the initiative.

Start preparing before the physical exam:

Because fear can prevent people from recalling what they talked about with the doctor at the time, notes should be taken. If possible, bring a friend with you to help you record any details you may have missed.

Questions that can be asked before the examination:

How accurate are the results of this examination? What are the shortcomings?

How long does it take to get the results? Why does it take so long? ?Will the doctor call to notify me, or should I call?

If I need to call myself, when is the best time and who should I call?

The doctor suggested that I call Can I read test reports online?

When they are most uneasy, many people will try to think the worst, says Guy H, a psychologist who teaches at Mount Sinai School of Medicine. "So when they get the report they can say, 'I knew this was going to happen,'" Guy H. Montgomery said. ?Or? Completely relieved. ?

The most troubled person may stubbornly hold on to this idea: If I look directly at the worst-case scenario that may have just happened without blinking, maybe this worst-case scenario will blink on its own. Blink away, and then only the good news remains.

Is there any use in worrying? Dr. Montgomery says he tells his patients: If you need a day to cry, you can. But if worry keeps you from taking care of yourself, we have to find other solutions. ?

Experts say patients can also use stress-reduction techniques that have worked for them during other stressful events. Such as self-hypnosis and yoga. Many patients find prayer reassuring.

Other people keep themselves busy without sinking into anxiety. Many people avoid feeling helpless by helping others. Or do something you particularly enjoy to fight off worries. (Shopping spree, has anyone done this?)

If anxiety leads to serious consequences, some people suggest medication. Dr. Elvira V. Lang, who teaches medical staff how to reduce stress in patients, thinks it's best not to take medicine.

After taking the medicine, you cannot drive, operate machines, or organize documents carefully, she said, "I strongly recommend that patients take deep breaths, inhale positive energy, and exhale useless negative thoughts." . ?

Dr. Montgomery believes that people overestimate willpower. ?Some might say ?Be strong!?? he said. But waiting for the results of an important medical examination? It is an unusual experience and a major event in life. Is it okay to ask for help?

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