If you can't deliver test results

Q: Occasionally, my office has trouble reaching patients whose test results are positive. If I haven't heard back from a patient after leaving three phone messages, what should we do next?

A: Check your records for anyone who may be able to help you connect with the patient: someone authorized to receive his healthcare information, for example, or listed in his chart as a contact in case of emergency.

If you can't find any leads, then send the patient a letter by regular mail instructing him to call you. You can include the test results and recommendations if you're sure he'll understand them and follow up appropriately.

If that fails to prompt a response, resend the letter by certified mail, return receipt requested. If that's unsuccessful, try one more certified-mail letter in which you directly spell out what the test results revealed, your recommendations, and what might be the result (including death or permanent disability, if they're possibilities) if the patient fails to get treatment.

Document each phone call (date, time, name of caller, and number called) and letter. Keep a copy of all letters and "return-receipt" cards from the post office.

If all attempts to reach the patient fail and the medical situation involves a potentially fatal or disabling condition, contact your medical malpractice carrier and follow its recommendations. Also contact them for guidance if the certified mail service confirms delivery but you doubt the patient's competence to act on the advice in the letters you've sent.