Take the Stress Out of Testing for Your Patients

By Lisa Mulcahy via Multibriefs

For most patients, medical tests are obviously necessary protocol — but they're not a lot of fun, for a number of reasons.

Testing can cause much more emotional distress to patients than many doctors suspect, in fact. A study from the University of Illinois at Chicago found that many people reported serious symptoms of anticipatory anxiety in a situation like waiting for test results, such as worrying for an entire day, which you obviously don't want them to do.

Concerns about testing cost, physical pain and not being able to understand what test results mean are other worrisome issues your patients may be grappling with, but not discussing with you. The positive news: you as a physician can do a lot to take the stress out of the testing process.

Try these constructive solutions:

Talk through your patients' fears.

The University of Illinois-Chicago study referenced above found that fear of the unknown is the reason subjects feel apprehensive while waiting — they don't know exactly when they'll get a call with their test results, for example.

Counteract this stressor with as much info as you can provide. Talk with your patient before he/she is given any test, explaining in detail why you've ordered it, what conditions results might indicate, and what will potentially happen as a result of any concerning results — will you retest the patient?

Refer him/her to a specialist? Prescribe a specific treatment or medication? As much knowledge as possible will give your patient a sense of control, and help quell those scary what-ifs.

Don't jump the gun when ordering tests, to save cost and discomfort.

A University of Michigan study found, for example, that physicians tend to order complex tests or biopsies for uncommon liver problems without first waiting for simple blood test results that would exclude those uncommon conditions. 86 percent of the patients in this study tested negative for anything serious in the end.

Covering your bases as a doctor by ordering a battery of tests all at once may save time, but for your patient, worrying about how they're going to afford these procedures, as well as the physical pain testing can sometimes cause is often unnecessary.

Go step-by-step toward a diagnosis whenever you can.

Help your patients avoid white coat syndrome.

As you no doubt know, white coat hypertension occurs when a patient's nerves may cause him or her to spike a higher blood pressure reading in when a doctor takes their measurement than is actually accurate. The syndrome is a frequent, frustrating problem doctors to deal with; in some cases, a higher blood pressure reading may impact test results inaccurately, too.

Telling your patients to simply relax may be the solution in isolated cases, but often, your patient is already trying so hard to calm down, the effort is totally counterproductive.

More proactive approaches to try: play classical music in your waiting room. Research shows that listening to a calming tune prior to getting a blood pressure check greatly reduced BP levels to provide an accurate reading in a range of clinical settings, plus reduced patients' heart rates as well.

Also, have your nurse take the reading — research from the University of Exeter shows that doctors who take a patient's BP routinely record higher readings than when a nurse takes the same measurement.

And just to be safe? Before entering an exam room, take off your white coat! If your patient first sees you in professional street clothes like a shirt and slacks or a skirt, that visual in itself may be calming enough to prevent a blood pressure rise. The most obvious solution often works best!

Be speedy.

Make sure your office staff members don't leave received results sitting in the fax machine or in an unopened email all day. Set a specific time each morning by which your staff will bring you test results for a review, so you can get those results to your patients as quickly as possible.

Explain test results in layman's terms.

Make sure you've slotted in enough time by phone or during a follow-up appointment to fully outline what a patient's test results mean in plain language, and answer any questions your patient has very specifically.

Again, give clear instructions as to what the patient will need to do next regarding further diagnostics or treatment. Routinely ask, too, if your patients have used a commercially available genetic testing kit on their own regarding a condition; this increasingly common practice can cause immense confusion when that patient is trying to interpret results on his or her own, according to Yale researchers.

Tell your patient that you, as a doctor, are most qualified and willing to talk through these results with them — and that it's always better to seek your advice regarding any worries about inherited illness in the first place. Trust and communication are always key!

Lisa Mulcahy is an internationally established health writer whose credits include the Los Angeles Times. Redbook, Glamour, Elle, Cosmopolitan, Health, Good Housekeeping, Parde and Seventeen.