You’ve probably received an email with a title like this: “New results have been uploaded to your patient portal.” And being human, you’ve probably viewed the results. When all the results come back normal, there’s no harm done. But, when results are released and show numbers or measurements out of normal range, anxiety can immediately spike. Unfortunately, these types of results are often uploaded to patient portals without notes or guidance from a doctor. Results without guidance leave ample room for anxious interpretations, internet research, and other less-than-helpful responses.

When Danielle, two months pregnant, noticed vaginal bleeding, she called her doctor and was instructed to get two rounds of bloodwork to be compared in order to determine if the pregnancy was viable or if she was likely to experience a miscarriage. Danielle’s test results became available to her through her patient portal on a Saturday morning when her doctor’s office was closed, meaning that she was able to view and interpret her results without guidance or direct information from her medical provider. Unbeknownst to Danielle, the lab had made an error; the information in the portal, which showed a significant drop in her hCG (human chorionic gonadotropin) levels, suggesting a miscarriage, was incorrect. In response, Danielle did what most people in her situation would do as a response to what she saw: she went to the hospital, thinking the situation required an emergency response. After waiting for five hours for a transvaginal ultrasound, she was assured that her results were incorrect and her pregnancy was healthy. Information is power, but information without proper guidance has the power to frighten us.

In the case of Danielle, we must resist the temptation to say, “All’s well that ends well.” Instead, we need to pay attention to the emotional impact of medical misinformation; the system’s failure to provide proper guidance; and its tendency to leave patients alone with test results and, therefore, with their own thoughts and interpretations of the information. The Hippocratic Oath, which instructs doctors to “first, do no harm,” must also include the emotional and psychological harm that can be done by the medical system’s tendency to leave patients on their own with test results and information. Danielle, pregnant for the first time at age 38, was already anxious about being pregnant at her age, and this experience, which easily could have been avoided, served only to increase her worry—not to mention, caused an unnecessary trip to the emergency room. A rethinking of the way certain aspects of the medical system function is pertinent to the discussion about illness anxiety and its preventable causes.

Danielle had done what most patients would do upon receiving test results. Patient portals are intended to provide accessibility and ease for patients but, without guidance, they can often exacerbate health-related anxiety. Here is my wish list for the medical profession:

• Understand that patients, even those not facing serious medical problems, can become anxious and be prone to overthinking and unhealthily researching portal results.
• Work to provide clinical guidance along with the release of portal test results in order to reduce patient anxiety.
• Recognize that “bedside manner” extends beyond the examination room, and that with our increased online accessibility comes increased responsibility to patients.
• Bear in mind that physical health is a source of anxiety for many people and, therefore, that an understanding of the psychological impact of test and scan results can be significant.