Scary medical messages

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Expecting test results? Tell your doctor how you want to be called in for follow-up

Diana Swift

©2012 Thinkstock

One Friday evening, Anna Lipinski returned home after a gruelling week in retail sales to find this message on her voice mail. ‘This is the breast screening centre. We have your mammogram results, and you need to call us as soon as possible to make another appointment.’ Needless to say, the 58-year-old Saskatchewan resident endured a harrowing weekend until the office re-opened the following week.

“I was in psychological agony, but on Monday I learned that there was no cause for alarm. Part of my mammogram was unclear, and they wanted to take another image, but I thought for sure it was the Big C,” says Anna, who had been undergoing routine mammograms without incident since she was 50.

And how about this mid-week message left for Guy Poirier, 54, a communications manager in Montreal? ‘Your blood tests are in. The doctor wants to discuss the results as soon as possible. Please note that the office is now closed and will reopen Monday.’

Overwhelmed staff in busy clinics often leave messages like these, but many clinics have policies in place to prevent alarming patients with messages open to the worst possible interpretation. “Our policy is never to leave voice mail messages for patients on Friday afternoons or before holidays,” says Marilyn Da Costa, an administrative co-ordinator at the CIBC Breast Centre at St. Michael’s Hospital in Toronto.

Da Costa advises patients to speak up at the time they come in for imaging and tell staff how they would like to be informed of the need for a return visit. Perhaps they’d prefer to be called early during the workday, so they can reach the clinic before closing rather than have a message left at home. “We also try to identify patients during processing who are unusually anxious or nervous about their results, and we give them special consideration, such as having a nurse call them to clarify why they're being brought back,” Da Costa says.

Then there’s the call that Janine Rhodes actually picked up from clinic staff. “This is May at Dr. Smith’s office. Your bone density tests are back and you have osteopenia. He wants you to come in right away.”

“What’s osteopenia?” asked Janine, a 48-year-old librarian based in Ottawa. “You’ll have to discuss that with the doctor,” came the reply. “I was scared because I thought I had full-blown osteoporosis.”

This is an issue that is top of mind for Dr. Frank Martino, a family physician based in Brampton, Ont. “How to train your staff to deliver messages is very important. I always tell my residents to put something in place that will not cause patients significant anxiety and have them ruminating for hours and hours over a vague message,” he says.

Another consideration is not knowing who’s going to receive that message, who has access to the patient’s voice mail. “A lot of patients don’t want their children or mother or their significant other to know what’s going on in their health care,” says Martino.

His clinic’s standard message, therefore, is very basic: ‘This is the doctor’s office calling. Please call us back.’ “If it’s something serious, I will personally make the call and make sure the patient speaks to me directly,” he says. “If it’s urgent, like a mass on a mammogram, I’d say, ‘I need to see you tomorrow first thing,’ and I will already have made an appointment with a surgeon.”

If a problem is minor — say a lost or inconclusive urine sample — Martino’s staff could be more specific: ‘We need you to bring in another urine sample; nothing serious. Call us back.’ “If a pregnant patient has had an unclear ultrasound, we’ll leave a message something like this: ‘Baby was unco-operative; a few things were unclear. We need to take a few more pictures. Give us a call.’”

Martino says it is more than appropriate for patients to tell staff how they want to be informed if they need a follow-up. “If a patient is particularly nervous — and I know my patients — I’ll tell them in advance, at the time of the test, to come back in a week to go over the results; that way, no message is left.”

In Martino’s view, doctors have an obligation to have a messaging plan in place, especially in this era of multiple electronic communication devices when people often don’t speak directly on the phone or face to face. “I give my staff very specific instructions,” he says. “I’ve had my share of those scary voice mail messages, too.”