Have you ever wondered if they post “bad news” on MyChart before the doctor speaks with you? They do!

[clifffaith]

Our previous doctor was part of the Providence system. Blood, urine etc test results would show up after the doctor reviewed them. Since we’ve moved Cliff’s test results from now come from his doctors at UCI through MyChart. Blood test results are near about instantaneous, and since they always draw blood right before his doctor’s appointment we look at the results together with him. I see his quarterly CT results (they are monitoring him to be sure his bladder cancer doesn’t return) about a week after the scans. I always assumed his doctors were seeing those before releasing them, but after seeing an MRI result 24 hours after he had the procedure, it looks like results are being released prior to the doctors reviewing them.

The joke in our home for years has been “how could we ever tell if Cliff has Alzheimer’s, he wanders around in a daze half the time anyway!” He is the quintessential absent minded professor. But over about the last four years, and more significantly in the last year I have seen a lessening of his cognitive skills. He drives with no issue whatsoever, but can’t use his iPhone for anything beyond a phone call no matter how many classes we take here at the Old Folks Home or how many times I show him how to Google something using it. He can play bridge, chess and poker still, but doesn’t know our phone number and comes to me every day (thank God) with various scam emails asking me how to respond to them.

So I think to humor me more than anything else, one of his oncologists said he’d refer us to a neurologist who then sent him for an MRI of his brain. The next day I see the test results (visible to Cliff too, but he doesn’t A) think to look and B) can never get into the system in spite of changing the password DOZENS of times and then not remembering it or writing it down).

Below is what I saw on MyChart which made me think “oh, the doctor doesn’t see this first and hold it so he can intercept bad news and deliver it in person”:

Severe volume loss in the mesial temporal lobes and parietal lobes superimposed on mild generalized volume loss. The findings can be seen in the setting of Alzheimer's dementia.

What the heck? Why would something like this be posted before input from the doctor? I kept this to myself for the next five weeks before his next neurologist appt. In the meantime he went for cognitive testing where he scored 26 on one protocol (or whatever it would be called) where below 26 is cognitively impaired, and 27 on another scale where below 50 is impaired. Yet he scored high on a smell test which apparently he would not have done with Alzheimer’s.

The doctor was noncommittal when we saw him just before Christmas, and never used the word Alzheimer’s, so we don’t really know what is going on. He put Cliff on Aricept (a drug prescribed to Alzheimer’s patients to slow disease progression). Cliff is nauseous (bad) and drowsy (good to sleep if queasy) from the new drug. It didn’t sink in to him that the doctor mentioned side effects, and I haven’t reminded him of this hoping the nausea will lessen as he gets used to the drug. I’m afraid if he realizes the drug is making him queasy he’ll stop taking it. When I first went on statins I had such muscle pain for three days I absolutely would have stopped the drug if I’d made the connection. I figured I had the flu and it was only months later that I read an article that made me realize I’d had temporary side effects.

 

[Luanne]

I never wondered because I pretty much knew the results were posted before the doctor reviewed them.

 

[JudyH]

My husband has had lower back/groin pain/pain in front of thigh for a number of months. At our appts with the same family doctor for check ups I told her about all this and I said it was time for a specialist to start looking and she agreed. I convinced her to order a lower back MRI although she said the specialist could order it. I nicely asked her to do it so the specialist would have a baseline to go from and not waste a few more weeks and more appts.
And yes, I got the results the next day. I have a medical background and I still googled every term so at least I can get the gist of what the specialist will say. My husband is sort of like Cliff and didn’t think about the results and leaves all the health stuff to me always.
I do think that if our report was bad news, our family doc would have called as soon as she saw it. Maybe.

 

[billymach4]

My mother clearly suffered from dementia. Now I don't know the fine medical definition of dementia vs Alzheimer’s but after numerous Dr visits, tests, evaluations no medical professional would ever commit to a diagnosis of dementia. We wanted a doctor to write a letter to revoke her Drivers License. We never got that letter.

 

[VacationForever]

Sorry about Cliff. I remember you had posted that he was getting confused and you thought it could have been from the bladder cancer. One thing to note is that Aricept mutes the symptoms for a while but does not slow the disease.

We always look at the results online the moment they are posted. We like to be informed before we see the doctor anyway.

 

[SusanRN]

My version of MyChart plainly states that results may be available before your provider has reviewed them. Too bad they don't all give that alert.
To billymach4 : Alzheimer's is one variety of dementia. There are many, including Lewy Body dementia, which my ex-husband was diagnosed with at 69 [and Robin Williams had].
Also, my state [Maryland], has mandatory self-disclosure of any physical or mental limitations upon renewal of a license or request for a replacement. Failure to comply honestly could presumably lead an insurer to deny coverage for an accident, I'm guessing. I would hope that a similar process is in place in other states.
The State then requires a follow-up evaluation by the physician, which asks about physical and mental risks, including alcohol or drug use, history of passing out from diabetes, etc. If there are any risks noted, the driver must receive a clinical evaluation, both in-office and on-the road, by a certified driver rehabilitation specialist (who are Occupational Therapists by training), have adaptive equipment installed in the car, if recommended (e.g., a spinner knob on the steering wheel or a left foot accelerator). and have 3-4 hours of driving instruction by the driver rehab specialist. If the driver rehabilitation specialist certifies to the state that the candidate has passed the evaluations and received training, then they must pass a State driver's on-the-road test through the Motor Vehicle Administration-- just like when they were first licensed as a teenager!
If a physician doesn't write to the Motor Vehicle Administration about a patient (maybe concern about breach of confidentiality -- or having the patient leave the practice), I would think a relative could write to the MVA and initiate the evaluation process. BTW, part of the driving rehab specialist's clinical evaluation includes questions that search for dementia.

 

[Timeshare Von]

Sometimes they do hold back the posting of results, but not always. While we were pretty sure my pathology would come back as ovarian cancer, I was shocked to see it posted on MyChart nearly a week before my follow-up appointment post surgery. My oncologist did apologize, saying that shouldn't have been posted until after my in-person exam/appointment.

 

[DebBrown]

My husband had a brain tumor removed a few years back and has regular MRIs to check for recurrence. The doc never releases the findings to MyChart before his appointment. I think this is can vary by doctor. I am sorry that you had to see the diagnosis that way.

 

[JudyH]

“a physician doesn't write to the Motor Vehicle Administration about a patient (maybe concern about breach of confidentiality -- or having the patient leave the practice), I would think a relative could write to the MVA and initiate the evaluation process. BTW, part of the driving rehab specialist's clinical evaluation includes questions that search for dementia.”

In Maryland my 3 sisters and I wrote and signed a letter to MD Dept of Motor Vehicles asking them to reevaluate our 95 yr old father’s ability to drive safely because he had a few fender benders and would not stop driving. At the same time I got his lawyer to tell him he would lose all his money if he caused an accident and got sued. DMV contacted him a month later for reevaluation and rather than do that he stopped driving. He had full time help at home that could drive him anyplace. He lived to 97 and passed during a massage.

 

[Talent312]

Quest Labs posts my results B4 my doctor's appointment.
I bring a copy of the results, but he gives me one anyway.
He's a bit of a cheerleader: "You're doing great."
Me: "What about this?" Doc: "Nothing to worry about."

-- One reason why I'm about to switch docs next week.

 

[rapmarks]

Quest Labs posts my results B4 my doctor's appointment.
I bring a copy of the results, but he gives me one anyway.
He's a bit of a cheerleader: "You're doing great."
Me: "What about this?" Doc: "Nothing to worry about."

-- One reason why I'm about to switch docs next week.

I am the opposite.
My doctor always wants to order more tests when I am a little off, sends me to specialists, requests more appointment. Oh for the good old days when they said Nothing to worry about.

 

[TheHolleys87]

“a physician doesn't write to the Motor Vehicle Administration about a patient (maybe concern about breach of confidentiality -- or having the patient leave the practice), I would think a relative could write to the MVA and initiate the evaluation process. BTW, part of the driving rehab specialist's clinical evaluation includes questions that search for dementia.”

In Maryland my 3 sisters and I wrote and signed a letter to MD Dept of Motor Vehicles asking them to reevaluate our 95 yr old father’s ability to drive safely because he had a few fender benders and would not stop driving. At the same time I got his lawyer to tell him he would lose all his money if he caused an accident and got sued. DMV contacted him a month later for reevaluation and rather than do that he stopped driving. He had full time help at home that could drive him anyplace. He lived to 97 and passed during a massage.

Hmm. I wish Louisiana would do the same. Unfortunately, he doesn’t have and would refuse help at home, and my sister the attorney has told us there’s nothing we can do currently to force him to stop driving or to move.