Patients’ Desire for Rapid Notification of Skin Biopsy Results Leads to Preference for Phone Call Over Face-to-Face Visit

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Patients’ preference for how they receive biopsy results “has shifted from face-to-face visit to discussion over the telephone because of a desire for rapid notification,” according to a survey of 301 patients recruited at three different melanoma clinics. Although 67.1% of the patients preferred to speak directly with their physician by telephone to receive their skin biopsy results, being notified in person at a clinic visit was “a distant second choice,” preferred by only 19.5%, Aditi Choudry, MD, of the Veterans Affairs Medical Center, San Francisco, and colleagues reported in JAMA Dermatology. Voice message and online patient portal were each preferred by 5.1% of patients, e-mail was preferred by 2.7%, and text message was preferred by 0.3%.

“Experience with online portal delivery of results favorably inclined patients toward that modality,” the researchers noted. The online portal was also favored by younger and more highly educated patients. The authors recommended that the biopsy consent form include a question about how patients preferred to be notified of the results.

Survey Details

Patients 18 years or older were recruited consecutively between July 1, 2012, and July 31, 2013, from melanoma clinics at three academic tertiary referral medical centers: University of California, San Francisco; University of Pennsylvania, Philadelphia; and Duke University, Durham, North Carolina. The response rate was 98.7%, with 301 of 305 patients agreeing to participate.

The mean age of respondents was 54 years; 96.3% were white; 88.6% had a history of melanoma; and 35.6% had a family history of melanoma. “In our study, women outnumbered men (53.4% vs 46.6%); in contrast, in the United States, more men (58%) are diagnosed as having melanoma than women,” the authors noted.

Preferred Method of Notification by Patients

Patients completed the questionnaire while waiting to be seen by their physician and before their clinic visit started and so did not know at that time whether a biopsy would be needed at that visit. They were asked their preferred method of being notified of a biopsy result in order of preference, why they chose a specific method, and if they preferred different methods of notification for normal and abnormal results.

“The most important consideration for patients was a communication modality that provided test results in the most rapid manner; 51.7% wanted a method that was rapid, and 7.8% preferred a method that was not only speedy but also allowed them an opportunity to ask questions,” the researchers reported. Meeting with the physician in person was rated very important by 19.5% of patient respondents.

Although 59.5% indicated they would choose the same communication method regardless of the biopsy results, 40.5% preferred different modes. For normal results, more of these patients would prefer voice message or e-mail rather than telephone, but for abnormal results, they would prefer to speak directly with the physician by telephone.

Preferred Method of Notification by Physicians

A second survey asked physicians at the three institutions to score the various methods of relaying normal and abnormal test results to patients. The response rate was 56% (47 of 84 physicians). The mean age of physicians was 43 years; the mean number of years in practice was 11; and 59.6% were women.

“Physicians’ overall preferred method of contacting patients aligned with patient preference for speaking by telephone (56.5%). However, for benign results, 31.2% of physicians chose to speak by telephone, whereas patients preferred voicemail (32.1%),” the authors noted. ■

Choudhry A, et al: JAMA Dermatol 151:513-521, 2015.