A significant but not often talked about shift in medicine has been the mandate for patients to get immediate access to their lab results even before a physician has reviewed them. This has generally been met with mixed reception from both patients and clinicians. Of course, it has some benefits. Most notably, patients now have full transparent access to their test results and they do not need to wait days, or in some cases weeks, for a physician to review and release those results. More medically literate patients who are able to make sense of their results may prefer this. And in the case of a patient who sees multiple doctors, it is now much easier for that patient to share and access their test results between different clinicians. If one of my patients gets labs done with a different office that does not send me their records, my patient can still easily access the results of those labs and review them with me if needed. Furthermore, having test results ahead of time gives patients a chance to prepare and think of any questions they may want to ask. Finally, in the cases where lab results are fully normal and in range, getting such results early can bring immediate peace of mind to patients who may get anxious waiting on their test results.
Despite such positives, there have been numerous downsides as well. Going back to the point of anxious patients, though getting normal in-range results can bring immediate peace of mind, seeing clinically insignificant but out-of-range results can cause unwarranted anxiety for patients who are unable to make sense of their results and assume the worst from it. Many such patients will even go on to pester their doctors, who are already greatly strained for time and resources, to now drop what they are doing to discuss these results and calm them down, which further strains the physician work force and adds to burnout. In cases where the patient does get a serious clinically significant result, such as a positive STD test or positive biopsy, getting the result without a physician to guide them through it can cause significant emotional distress while they wait to hear from their doctor.
If a patient gets a concerning biopsy result on Friday and cannot hear back from their doctor until Monday morning, they are left to deal with the anxiety and stress of that result on their own for days. I have heard of a case of a patient even self-harming due to the emotional distress caused by a bad test result that came in and not having a professional to talk them through it. In cases of hospital medicine, where patients are actively being managed and treated inpatient as their results come in, having test results available in real time to admitted patients adds additional complications as concerned patients or their family members may recurrently ask for the hospitalist or nursing staff on call to discuss results throughout a shift, or they may try to intervene in their management based on the results they see.
It’s unlikely that immediate patient access to test results will change, but there are some solutions that may help make everyone happier and allow us to minimize the negatives while retaining the positives. First and foremost, patient portals should give patients the option to voluntarily opt in or out of seeing their test results prior to the doctor reviewing them. Patients who are more medically literate or feel comfortable seeing their results ahead of time may opt in, while more anxious patients who would rather speak to their doctor first may opt out. Since the pros and cons of getting results early is very much dependent on the individual patient and their situation, it’s only fair to allow them to opt in or out of it based on their needs or preferences.
Prior to patients accessing their test results, the portal should also place a disclaimer stating that some values may be out of range but still considered clinically insignificant and that final clinical analysis must be deferred to their physician. This disclaimer should also add that seeing these results sooner will not change the wait time to hear back from the doctor so please proceed at your own discretion and allow reasonable time to hear back from the physician prior to contacting them.
Until such changes are made in the portals themselves, we can give these disclaimers to our own patients at the time of ordering labs and set expectations with them early on. If I am ordering labs for a patient, I will sometimes preface and tell them that some results may return out of range but it’s usually not something to worry about, and that if something is truly serious or urgent, I will contact them immediately. If they don’t immediately hear back from me, then that is usually a good sign, and they are okay to wait to hear back from me first.
Another practice that has saved me some time and stress is to message patients over the portal as soon as the lab results come in and not wait for the patient to contact me first. If I see a set of lab results that are out of range but still reassuring, I will send a quick message to the patient that all the labs look good. This brief message does not take much time to send, but now the patient is not left panicking over some out-of-range values and demanding immediate phone calls with me to calm them down, which ultimately becomes far more time-consuming. If they have additional questions despite my message, then I will ask them to schedule a follow-up visit to discuss.
Some test results also allow a release feature, and I find this advantageous to use as we as physicians can defer releasing results until we plan to discuss it with the patient or only release results ahead of time that are clearly normal. Some other ways to navigate labs is to order them just prior to the patient’s visit. This way, the patient already knows they have a follow-up scheduled to discuss labs shortly after the results come in, and they don’t feel the need to demand an immediate call back or feel like they are having to wait to hear back from their doctor. Of course, the main downside of this is that patients may no-show after their results come in, and it is not always clear what labs a patient will need until they are seen and assessed in the office first, making it hard to order the correct labs prior to their visit. None of these solutions are perfect or work in every case, but they can be useful tools in the appropriate situation.
Although there will still be pitfalls with the early access to labs that patients get, and this will continue to be a double-edged sword, I hope this article provides some benefits, downsides, and, most importantly, a few possible solutions to help make navigating such labs better for patients and their clinicians.
Where should the line be drawn for patient access? Share in the comments.
Dr. Shadman Sinha is a general pediatrician practicing in New York. His passions are speaking out about healthcare reform and educating parents via his many social media accounts. He also loves rocking out on his guitar and playing with his band. He posts regularly on TikTok, Instagram and YouTube @docshaddymd. He is a 2025–2026 Doximity Op-Med Fellow.
Collage by Jennifer Bogartz / Shutterstock
