A radiologist's frustration leads to missed communications. How far must you go to ensure crucial follow-ups happen?
No one likes being put on hold, but, as one physician found out, there is no substitute for direct communication when a patient's life is in jeopardy.
Ms. T, a 28-year-old African American, went to her HMO to see her primary-care physician, Dr. M, about pain in her calf and ankle. Suspecting a muscle tear, he referred her to a radiology practice for an x-ray of her ankle and a Doppler ultrasound of her calf to be performed the next day. He scheduled a follow-up at the end of the week.
Ms. T reported for the tests as scheduled. After she left the premises, the ultrasound technician brought the images to Dr. C, a diagnostic radiologist.
“Something looks off here,” he told the physician. “I advised the patient that she should probably call her doctor.”
Dr. C studied the images and diagnosed deep venous thrombosis (DVT), putting Ms. T at risk of a pulmonary embolism (PE). The radiologist immediately dialed Dr. M's office. After working her way through the automated menus, Dr. C finally reached an operator, identified herself as a radiologist, and stated that she urgently needed to speak to Dr. M.
The operator put Dr. C on hold while she tried to locate Dr. M. The radiologist stared at her wall clock and watched the minutes tick by. Slamming the phone's buttons and yelling “Hello! Hello?” into the receiver had no effect.
Finally, she hung up in frustration. Rather than risk another irritating delay by calling back, Dr. C decided to fax her report and gave it to a receptionist for transmission.
Meanwhile, the patient called Dr. M as the ultrasound technician had instructed and was told that her results weren't back yet. In fact, the fax never made it to Dr. M's office. Later that week, Ms. T had a child-care emergency and missed her follow-up appointment. She assumed that if the results had come back, Dr. M would have called.
Two days later, she was found dead from a PE. Her distraught family hired a plaintiff's attorney and sued Dr. C for negligence.