For a physician, ordering a medical test is a routine, almost mundane part of the daily workflow. For a patient who’s in for anything but a wellness visit, though, the experience is far from the norm. And if they don’t understand why tests have been ordered and when to expect to hear about the results, it can lead to unnecessary worry.

“It’s such a routine part of what they do, many doctors may take for granted that the patient knows — that’s how it works,” said Richard L. Street, Jr, PhD, a professor at Texas A&M University in College Station who studies doctor-patient communication.

But research shows that, more often than not, the patient doesn’t know many details about their testing. That gap — between what a physician thinks they’ve communicated and what the patient actually grasps — is where anxiety thrives. And it’s largely preventable.

A Bigger Problem Than It Looks

More than 14 billion lab tests are performed in the US each year, a number that’s only expected to go up. Most are routine. But “routine” is a clinical word, not a patient word.

A 2022 qualitative study clarified this disconnect by comparing physicians’ and patients’ separate accounts of the same testing encounters. The findings, published in the British Journal of General Practice, reveal a mismatch: Physicians assumed patients knew how to access results and that no news was good news. Patients, meanwhile, were often left guessing — waiting for a call that didn’t come or staying silent to avoid seeming demanding.

That silence may extend past a single round of tests. Once a patient learns they can’t count on clear communication, they may lose trust in the testing process itself — as well as the physician responsible.

You probably won’t hear any pushback during a consultation, Street said. “But once the consultation is over, a patient that’s unhappy or anxious could easily be less cooperative. They may not do the tests that they need, or it may mean that they go doctor shopping.”

What Patients Need

When Australian researchers asked patients in acute care what they wanted most from their diagnostic testing experience, the answer was resounding: They wanted to know why a test was being given. And they didn’t want a complex medical explanation; they wanted it in plain English.

The study, published in Health Expectations in March, found that patients needed to be told what happens next: what to do if results are abnormal, when they should expect to hear back, and whom to contact if they don’t. That’s particularly important when patients are stressed or unfamiliar with you as a physician. A systematic review of 71 studies on test communication confirmed that patients aren’t just anxious about bad news — they’re anxious about uncertainty.

Alleviating that uncertainty is easier than you might think: It comes down to managing expectations before the patient ever leaves the exam room.

Test Communication Strategies That Work

Start with the human element. Building rapport isn’t just about bedside manner — it is a critical tool for information gathering. Yet a 2025 study in BMC Medical Education found that 20% of outpatient encounters didn’t include so much as a basic greeting.

“One of the best things doctors can do is get the patient talking early,” said Street. “Start with general talk about family and overall health. As they’re talking, you’re getting explicit information about where they’re coming from.”

Ask what they’re afraid of. Don’t guess. It’s entirely reasonable to ask, “What are you worried this might be?” said Anne Cappola, MD, executive director of the Penn Medical Communication Research Institute in Philadelphia. “Sometimes you can reassure them on the spot. If they say, ‘I’m afraid it’s cancer,’ you can say, ‘Oh no, we’re not thinking about that.’”

It’s also a moment to account for patient history. A patient who recently experienced a second-trimester pregnancy loss, for instance, will naturally carry a much higher baseline of anxiety into routine prenatal testing in a subsequent pregnancy.

Don’t mistake compliance for calm. Patients who seem calm often aren’t. “Be very careful about thinking you can tell when someone’s bothered,” Street said. You have to actively probe: “You said you’re fine but without a lot of enthusiasm. It seems like you might be worried about something?” Once you invite them to open up, it makes space for the real concerns to surface.

Take extra care with new patients — and new tests. When you don’t have years of built-in trust with a patient, spending 30 seconds on small talk is a clinical investment. Even with a long-term patient, a test that deviates from their usual baseline requires a conversation.

“Explain why you’re doing it,” Street said. “Then explicitly ask, ‘Would that be ok?’” Give them the floor to ask questions.

Never assume patients know how to check results. As the British Journal of General Practice study highlighted, patients often leave the clinic completely in the dark about this, even when doctors think they’ve explained the process clearly. One patient had never proactively checked his results in years of care — he just assumed someone would call if anything was wrong.

Build in a two-way communication channel. Telling a patient to “reach out with questions” is an empty gesture if they can’t actually reach you without an appointment. If your portal allows you to message patients but doesn’t allow them to reply, say so explicitly and provide a clear, alternative route to a real person.

Demystify the ‘abnormal’ flag ahead of time. The best defense against a confusing or alarming result in the portal is a heads-up delivered in the exam room, tailored to the clinical scenario. Cappola suggests two approaches:

1. If you suspect a specific diagnosis, give your patient a heads-up. “Based on your symptoms today, I think you may have a thyroid problem. If this test comes back with a high number, that just confirms it — and we’ll talk about next steps.”
2. If you’re still investigating, frame the test as a tool and give your patient a hard deadline for peace of mind. “We need to find the source of your symptoms, so we’re going to order some tests. I’ll follow up with you as soon as they’re in. If you don’t hear from me within 3 days, please reach out to the office.”

Left to their own devices, “they get a result they don’t understand, and they have access to AI,” said Cappola. “[But] there’s a reason AI isn’t your doctor.” A few moments of preemptive framing can head off excessive worry.

A 2-Minute Script

You don’t need to have a lengthy conversation every single time you order a lab. But before you move on to the next appointment, you can help reduce your patient’s anxiety by covering these five points in 2 minutes or less:

1. Why you are ordering this specific test
2. What the results could mean — whether they come back normal or abnormal
3. When and how they should expect to hear back
4. What to do if that deadline passes and they haven’t heard anything
5. An invitation for them to ask questions right now

The experts cited in this article had no relevant disclosures.