When multiple physicians take part in the care a patient it may be critical for them to relay important diagnostic results as well as follow-up and treatment advice to the patient and to the other physicians. Patients generally believe that the doctor will inform them in case there are any serious findings from tests ordered by the doctor. Generally, when people do not receive a follow up communication from a doctor many interpret that as an indication that everthing is fine and that there is no need for them to follow up with the physician. Consequently when a doctor has information or reaches a judgements that the patient requires immediate follow up or treatment it is important for that physician to communicate that to the patient and possibly also at least the patient's primary care physician.

Consider the following reported lawsuit. A number of doctors had a chance to diagnose the male patient’s prostate cancer when it was still in its early stages. A man went to his family doctor complaining of urinary problems. He was 56 at the time. The family physician assumed that the patient's problems were not because of cancer. As a result, the family doctor did not order any diagnostic testing, for example a biopsy and failed to refer the man to a urologist.

Ten months afterwards the individual consulted with a urologist who did a digital examination on the prostate gland and ordered a PSA blood test. The patient then found out that the urologist was not approved by his insurance and he went to a different urologist who was approved.

The PSA test ordered by the first urologist came back and that urologist advised a biopsy. However, that recommendation apparently did not get related to the family doctor or the urologist approved by the insurance company. The second urologist concluded that there were no abnormalities present with the prostate and that there was no evidence of cancer.

Therefore the cancer went undiagnosed for two years at which time it had spread outside the prostate. By that time, the cancer had spread beyond the prostate and was now advanced. Had the cancer been diagnosed at the time the patient initially told his physicians that he had urinary problems, when he saw the first urologist, or even when he saw the second urologist, it would not have yet spread and, with treatment, the patient would have had approximately 97% likelihood of surviving the cancer. Because the cancer was by now advanced , however, the patient was likely to pass away from the cancer in under five years. The law firm that handled this lawsuit revealed that they were able to obtain a settlement during jury selection at trial in the amount of $2,500,000 on behalf of the patient.

This claim thus demonstrates two main varieties of failures. There was the failure on the part of the PCP and the second urologist to not follow the proper screening guidelines. Additionally there was the failure of communication among the several doctors. While there is no way to know if the PCP or the second urologist would have followed up on results of the PSA test from the first urologist or on that urologist’s suspicion and recommendation they at a minimum would have had information and perspective they were missing.