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A Piece of My Mind
June 7, 2016

You’ve Got Mail

Author Affiliations
  • 1Bobby R. Alford Department of Otolaryngology–Head and Neck Surgery, and Center for Professionalism in Medicine, Baylor College of Medicine, Houston, Texas
JAMA. 2016;315(21):2275-2276. doi:10.1001/jama.2016.1757

You’ve got mail. An alert pops up announcing a new message from the portal for my electronic medical record. Previous correspondence had been mundane, but this time I was surprised to receive the results of my recent colonoscopy. I am—or, until that moment, had considered myself to be—a healthy person, in surprisingly good condition considering my age and my distaste for exercise, so I was blindsided to receive the pathology report describing in cold clinical terms the abnormal histology of my tissue fragment. The biopsy results suggested an unexpected benign, but chronic, disease. My mind reeled, my self-image collapsed, and suddenly I was alone on a sea of alarm and confusion. Later that day, I was able to speak to my gastroenterologist on the telephone. I expressed to him my surprise at the findings and my dismay at the way I had received the results. I asked whether this had been sent to me by email because I am a physician and thus presumably more capable of understanding the information (which, it turns out, was a false assumption). “Not at all,” he replied. “It is mandatory that all patients receive biopsy results and lab values within 48 hours.” “Wait,” I replied. “Any abnormal biopsy or lab value? Directly to the patient? In an email?” This seemed implausible. “I could get an email that says I have breast cancer or my husband could get an email to learn he has prostate cancer or diabetes?” Sounding a bit defensive, he informed me that this is an institutional rule, not his personal decision: all patients must receive all laboratory results, including biopsy results, normal or abnormal, within 48 hours.

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