Navigating the Health Care System
Advice Columns from Dr. Carolyn Clancy
Former AHRQ Director Carolyn Clancy, M.D., prepared brief, easy-to-understand advice columns for consumers to help navigate the health care system. They address important issues such as how to recognize high-quality health care, how to be an informed health care consumer, and how to choose a hospital, doctor, and health plan.
Asking Questions About Medical Tests
A registered nurse in her mid-40s, Nancy Keelan was concerned that her heavy, irregular bleeding could be something more serious than the start of menopause. But her doctor did not agree and told her on several occasions not to worry.
Three years later, at age 46, Keelan discovered she had advanced endometrial and ovarian cancer.
Today, she speaks to women's groups and advises them not to wait to see their doctors if they develop new, unusual symptoms, according to a recent CNN news report. Keelan also urges women who are worried about new symptoms to ask their doctors if they should be tested to diagnose or rule out a disease or illness.
If a nurse like Keelan—who is familiar with medical tests and terms—didn't insist that her doctor perform a test when she experienced symptoms, I wouldn't be surprised if you were also reluctant to ask for a test. That's why her story and her advice are so important. Asking questions about medical tests—which ones you need, which ones you don't, and what the results tell you—can help you stay healthy and alert your doctor to the signs of a medical problem.
A wide array of medical tests are available today that can detect disease or illness at an early stage, when many conditions can be treated effectively. Your physician shouldn't prescribe tests that you don't need, but you should get the tests that are right for your age, gender, and medical history.
Maybe you don't know why you need a particular test or don't understand how it will help you. Here are some that my agency, the Agency for Healthcare Research and Quality (AHRQ), developed to help you talk to your doctor.
Ask your doctor:
- How is the test done?
- What kind of information will the test provide?
- Is this test the only way to find out that information?
- What are the risks and benefits of having this test?
- How accurate is the test?
- What do I need to do to prepare for the test?
- Will the test be uncomfortable?
- How long will it take to get the results, and how will I get them?
- What's the next step after the test?
Your doctor should be able to tell you when the results of your medical test will be ready. Do not assume that everything is fine if you don't hear from your doctor. Tests results can get lost, or people can think someone else gave you the results. No news is not necessarily good news.
In fact, a study conducted at Harvard Medical School found that up to 33 percent of doctors did not always notify patients about abnormal test results. If you don't hear from your doctor, call to get your results.
It is also possible that your test results are incorrect. If you or your doctor think the test results may not be right, retake the test. A second test can confirm or rule out a diagnosis.
It's also a good idea to get information on the lab your doctor uses to analyze test results. For example, you may want to know if your doctor uses a lab because he or she has a business arrangement with them or if a health insurance company requires your doctor to use a certain lab.
You can find out if a lab is accredited by or has a seal of approval from groups such as the College of American Pathologists or the Joint Commission. Both groups require labs to meet certain standards, which are linked to better-quality services.
If you need a mammogram, which is a test to detect breast cancer, make sure the test is performed at a facility that is approved by the Food and Drug Administration. You can ask this when you make your appointment, or you can call 800-4-CANCER to find out the names and locations of approved facilities in your area.
By asking your doctor questions about medical tests and your test results, you will have the information that you need to make smart decisions about your health care.
I'm Dr. Carolyn Clancy, and that's my advice on how to navigate the health care system.
Agency for Healthcare Research and Quality
Quick Tips—When Getting Medical Tests
College of American Pathologists
Laboratory Accreditation Program Inspection Checklists
Joint Commission Requirement for Laboratories
U.S. Food and Drug Administration
Mammography Web Site