Went to a new endocrinologist (Dr. Jones) for diabetes eval. He tells me he treats osteoporosis too. I had had a bone density test done at the hospital (St. John’s) where he practices but the results weren’t back at the time I saw him. So he says to call back in a few weeks. In the meantime, another endocrinologist (osteoporosis specialist) at St. John’s I had consulted mails me the results and says all is normal.

So I call Dr. Jones for his thoughts on the results and his clerk says he “does not practice over the phone.” I said how is telling me what he thinks of the results “practicing?” She answers, “Well he’s giving you medical information isn’t he?” She ends by saying that she’ll have him call me if he needs to. No phone call the entire week.

I email him on May 15 with the same question…what does he think of the results (Remember, I only went to see him for a diabetes eval…he was the one who broached the bone density test.)

So far have not received any response. I know it’s too soon but my question is: since when does an m.d. not discuss test results w/ a patient over the phone? I had waited 4 months for an app’t with him. I would make another if that’s what it takes but has anyone ever been told an m.d. doesn’t “practice over the phone?” Am I being unreasonable? If not, do I just find another m.d.?

Antonia,
I certainly for one do not believe that discussing the results of a test he had ordered, over the phone is out of the ordinary. If it's too complicated or time consuming, then the office should tell you that you need to make a return visit and schedule you for another appt. Perhaps you could get the test results from the facility that ran the test. If not, I'd call back and ask if you are to make a return appt to discuss the test results. Looks like to me they are leaving you hanging with no answer.

Billye

Antonina: He certainly CAN discuss the results with you on the phone; doctors do this all the time. But why do you want him to? You've already been told by an endocrinologist that the results are normal and you have the results in your hand. I don't get it that you want him to call you about something you already know about. Am I missing something?

Doctors are banned by HIPPA law to reply to emails from patients. Emails are considered public, and so using them violates privacy law.

However, some people find it helpful to FAX a note to their doctor when they feel they are unable to get past the secretaries. You might fax a nicely worded, humble note, saying...I believe you received the results of my bone density; I don't want to take a lot of your time, but, if there isn't anything extraordinary that needs to be discussed in person, I'd really appreciate a phone call telling me the results. If there's something that requires treatment, please let me know.

That might work, if you need his input for some reason.

--from my knowledge of HIPAA, that e-mail is off limits.

Password protected e-mail systems on both ends certainly qualify as "private"; at least as private as phone conversations, given current eavesdropping technology. They're certainly more private than faxes, and I have certainly had doctors who will fax lab resutls to a patient with the patient's consent. (I have also set up a fax to e-mail number through E-fax for that reason.) And, there are doctors who communicate by e-mail. Among those that don't, I think they are just uncomfortable with the technology--or, more likely, especially in your case, they're just trying to get you to come in for another office visit so they can bill you, and insurance, for it. THAT'S my suspicion when some secretary says the doctor "doesn't practice over the phone".

There are a lot of things about HIPAA that doctors and their staff tend to believe that are patently false. For instance, I've been told by some medical office staff that the doctor cannot send me or give me a lab result without discussing it with me first, and that this is a HIPAA regulation. It absolutely isn't--and I tell them it's simply their office regulation, and to read their HIPAA material better (and I always politely offer to send them some).

I like to start them with this article:

http://www.nytimes.com/2007/07/03/he...5NKiKQSE3tX6cg

I will even send them the entire original act:

http://aspe.hhs.gov/admnsimp/pl104191.htm

The point is, HIPAA, in sum, is designed to prevent discussions or revelations of individual medical info WITHOUT THE PATIENT'S CONSENT. If the patient consents, this flow of info is not to be diverted. It's why I often given a new doctor a letter stating that s/he is allowed to discuss my medical condition with other docs I have, members of my family, and even a few friends whose judgment I trust in the event I'm incapacitated.

The other stuff that is claimed in the name of the statute is bogus (as the article describes), and has already led to some troublesome lawsuits--exactly the opposite of the original intention.

I suspect your doctor's office is just being hidebound (and greedy).

Thanks for your responses Silverlady and Glenntaj.

Just a clarification of why I might want Dr. Jones to give me his opinion on the test even though I was told it was “normal.” The m.d. who originally ordered the test while very nice and very willing to speak with me by phone strikes me as less thorough and less “engaged” than Dr. Jones and I would have liked to keep seeing Jones. Moreover, Jones seemed to want me to switch to his care and was very interested in the outcome of the bone scan.

As far as there being a greed factor involved, I doubt it. Jones has a thriving practice (I had to wait 4 months for an app’t.) I don't know if I could get another appointment without having a 2 or 3 month wait.

I think faxing might have worked better. I wish I had thought of that. The other side of this is that I might seem like a stalker if I now fax him with the same request!!

Re: HIPPA....if I'm the person (patient) emailing, isn't that granting the md implicit consent to release the info to me? I like the idea of presenting a letter which grants specific consent. It cuts out all the paperwork involved when you want other docs to get your medical records, etc. Thanks for the suggestion Glenntaj.

My neuro has emailed me Rx info, and my titration schedule to replace Neurontin w/Lyrica.
My PCP also has responded to my emails (but doesn't like me to email her, unless absolutely necessary, and I cannot get thru the group practice office staff.)
Bob B

Antonina:

Regarding faxing a doctor's office (especially if it's a BIG practice). I have done this. And the doctor never got the faxes. It doesn't go to him immediately by the way.

Fax machines are usually in some back room (absolutely every one of my doctors, have their fax machines in a back room). The staff has to go and check ALL THE FAXES, and sort them out, and find which fax goes to which doctor.

Now if you have one doctor in the office with one staff person, well, that's a whole easy thing going on there.

But, let's take for example, the orthopedic department of Beth Israel (where we went last week).

We are talking Many doctors, many various office cubicles, many staff members, many department heads, many this and many that. And if you have one fax number, well FORGET about the doctor ever getting the fax. He MIGHT, and then again, HE MIGHT NOT!!!

And calling to speak to a doctor (very rare to get them on the phone initially). I got lucky the other day when I phoned Alan's doctor. AND THAT'S A BUSY OFFICE, BELIEVE ME.

In Alan's primary docs office, there are two doctors, with about 10 girls in the reception area, doing different stuff. Like HMO calls, billing, stuff, answering questions, taking blood. I would never fax that office because he would never get the fax. I've tried this, I tried calling after I faxed and I was met with "you faxed us?? when did you do that, the fax machine is at the other end of the office".

Now one would think. "this is 2008", why isn't their fax machine right up there next to the phone, in the reception area??

Because the fax machine would be going all day long, and driving everybody crazy, (but that's just my train of thought).

And the only doctors I know that does emailing is my dentist, and Alan's ortho guy. Alan's ortho guy has an email address but I rarely correspond this way. You have no idea how much spam that people get in their emails. That's why doctors today really don't like to do emails. They have to either sit down at the computer, and sort out their emails, or they have to have their secretaries do this for them. Not good time management.

When I take a blood test, I am told to call in 3 days. Then they will either fax me the results, or I can go and pick it up. They also say "if there is an irregularity, that's the only time the doctor will call you back and speak to you about the results". "But if you want to make an appointment and come in and go over your results, well that's fine".

So the message I'm getting on this is "we'll call you only if we find something wrong with your blood tests".

But the nonsense that you were told about "He can't discuss blood tests results with you over the phone", well, that's just plain bull *****.

I do not understand why you were told this.

I have always spoken about blood tests over the phone... ALWAYS.

So I wish you well on your journey of result gathering.

Best of luck.

Melody

Hippa is very misunderstood by doctors offices and hospitals. I have been told that i would have to sign a release to authorize myself to receive copies of my tests at a number of doctors offices. In 2003 when the law had first taken effect i went myself to the emergency room of North Shore Hospital for chronic asthma for 5 weeks 24/7. They admitted me and i asked them to call my wife and tell her and they said they couldnt do that under Hippa. I said i'll sign something , they still said no so i just grabbed the phone off the desk and called myself.

Melody, you've captured the faxing mish mash very well. I've had all the back & forth you've experienced. The diabetes md is a solo practitioner so I don't think the fax would be as likely to get lost as it would in a group practice. I think, however, that the rude office jerks would somehow "misplace" it. A little paranoia is creeping into this whole situation.

Nide, you are truly lucky. The only md who ever responded to my email is the friend of a friend and so would maybe ignore it if not for fear of pissing off our mutual friend.

HIPPA looks like it's a nightmare to understand. Hey Joe, you were smart to get on the phone yourself. Luckily, you were not out of it and unable to take charge.

NEVER underestimate the passive aggressive helpers in a doctor's office!

My husband audits them...they are very underpaid and in return their egos
grow in a compensatory fashion.

My Doctor's office has some doozies!