Speaking as a PCP, I am not sure it is safe for the ED to not take the initiative in contacting
someone about abnormal labs that require follow-up. I don't think there is a system reliable
enough not to require the ED attending's review. I don't think it's ever safe for an ordering
physician to expect that another person is following-up on results.
Some people still do not have PCPs. Of those who do, many do not make an appt for the
PCP follow-up that is often recommended by the ED. The PCP copy of the ED form
sometimes doesn't get to me at my office for a long time. I am happy to do follow-up, but
the proper information doesn't always make it to me.
On a few occasions, an ED attending has called me in my office or paged me on-call to tell
me about an abnormal lab, in order for me to handle it. It is harder to for me to do myself
after office hours when I don't have records at hand, etc.
Mike Webster, MD
> I wonder if there is any consensus as to how to handle telephone calls
> by patients/families looking for results of labs/cultures? Knowing that
> most ED's have a policy discouraging entertaining such requests, does
> any one feel "obligated" by medicolegal pressures to respond by giving
> For example, a patient fails to improve after discharge from the ED (to
> make it easy, say it's an infant with fever and no other source), a
> parent calls asking for information, knowing that a culture is pending,
> they are told by a "staff person" that "it's against policy to share
> such information by telephone", the caller is angered, the patient does
> poorly, etc etc.
> How does everyone handle such situations? Do you call families or
> patients with positive cultures obtained in the ED? (for example, a
> child suspected of having a UTI at the time of discharge is placed on
> amoxicillin empirically - the culture grows amp-resistant E coli, and
> sensitivity testing suggests a change in therapy). Do you have a
> mechanism in place, or do you feel responsible, to follow up with these
> We are re-evaluating our current process, and would appreciate any input
> that you may have. Thank you.
> Norm Christopher
> Children's Hospital/Akron
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