Hi. I am Mr. Lab Tech. You may remember me from such tests as “11pm CBC” or “salicylates q2h” or “1am electrolytes” or “2am RSV” or “5am cardiac panel” or “6am INR” or “the reason why I’m at my next shift without sleeping at all is because of you”
No? Well, the reason I have worked 30 hours in the last 48 is YOU. Can you tie your shoes without a lab test indicating you do so?
Lest you get the wrong impression, I don’t have a problem being called in for lab tests when they are necessary. “STAT” testing on an on-call basis means that the results of the test are going to determine the immediate treatment of your patient. It does not mean “Well, gee, I’d like this done now because that’s the way they do it in Toronto”. Guess what? This is not Toronto. Why don’t you stay there instead? By the way, calling me in in the wee hours of the morning because you lost a report (whose values were all normal) to print another one is not a good allocation of healthcare dollars. Is it so much to ask for 2 hours of uninterrupted sleep?
I know I am not an MD and am not able to correctly judge the need for lab tests. However, how come any time I am on call with you I am called in 5x more than any other doctor? Are you that unlucky?
Also, I don’t think I am the person you should be asking if results X equals respiratory alkalosis. I’m pretty sure it does, but I am not sticking my (not nearly as educated) neck out for something that is supposed to be your job. I run the tests, you treat. Get it? Asking me those questions doesn’t ring any alarm bells for you? Maybe if you can’t figure respiratory alkalosis from your own asshole you should stay at your family practice in Toronto and deal with sore throats and upset stomachs.
A physician who is ordering many more tests than his peers, especially stat tests, is someone who needs to be looked at by the appropriate hospital oversight committee.
It should be the job of the laboratory director to initiate procedures for such a review, not merely to prevent wear and tear on the techs but also to save money.
Excess tests (and the increased chances for false positives) also lead to overtreatment or inappropriate treatment of patients.
Ha! You are absolutely correct, sir (or madam). I am 110% in accord (which is a dangerously high degree of accord) with what you are saying.
Unfortunaltely, up here in the boondocks, we have no pathologist (ie lab director) and our chief lab tech (and all techs when she is not available) serves that role. This particular chief lab tech is more concerned with making herself look good to management than of actually doing anything properly. Oh, the stories I could tell (that is another thread entirely).
I am rested up now and only have to deal with this crap for another couple of months. I am going back to school, hopefully to become a good MD who doesn’t abuse lab tests. (we’ll see).
I was recently discussing with a friend how easy it would be nowadays to pretend to be a doctor.
My doctor shows me all my pathology results and discusses them with me. Any abnormalities are flagged and generally some hint is given as to possible causes.
So my plan would be lots of tests for everyone. If anything looks too tricky either off to hospital or refer to a specialist.
I honestly can’t recall the last time I visited a doctor without some idea of what I had.
[I honestly can’t recall the last time I visited a doctor without some idea of what I had.
[/QUOTE]
I can beat that. Not only do I already know what I have, I also already know what I need from them. If I could write my own damn prescriptions I wouldn’t even visit the doctor anymore.
Better than that, I have already cured myself before even thinking of visiting the doctor. If I can refine the technique further, I will be able to regress in time to before the symptoms began and never feel sick at all.
By the way, Nunavut Boy, there are three STAT 24-hour fecal fat specimens waiting to be processed before you leave. Don’t forget your mask and goggles.
Collect all the stool a person produces for a time period. 72 hours is a common time period. Measure how much fat goes in via the diet. Assay the stool to see how much fat comes out. This will tell you how badly the person is malabsorbing fat.
I’ve been involved in collecting a 72 hour sample more than once. It ain’t fun
The nurses in my clinic tell me that the biggest difference they see between first year and third year residents is that third years see twice as many patients and order half as many labs.
If anything, I’ve probably swung in the other direction. My interns are scared to hear “Why didn’t you order lab X???” from the attending on rounds, but I try to teach them that if they get every diagnosis on the first day, they’re ordering too many tests. The best thing about having someone in the hospital is that you get what I consider to be one of the best pieces of diagnostic information–how the patient does clinically over 24 hours.
The biggest problem I have with labs in our place is not getting them done, but getting them drawn; most of the time when I need labs in a hurry, it’s on a patient who is still in the ER, since our hospital is so full these days that it takes several hours for an admitted patient to get to the floor and the ER is totally not set up to board patients. Once it actually gets to the lab, it’s usually done in no time.
I’m sorry you’re stuck working with a dickwad doctor. Move to YK where there are GOOD doctors and still get the NLA on your taxes and a lower cost of living.
Hee hee hee. I’m not an RT anymore. I don’t have to collect blood from a patient to test their glucose levels fifteen times in a long weekend because the doctor ordered it to be done 5X a day then went out of town and forgot to cancel the order even though it came back normal every. stinking. time. Hee. I don’t have to play with other people’s blood, pee, shit, mucous, sperm, vaginal secretions, and swabs of every part of the body anymore. Well, I still can, if I want to. I rarely want to though. Although I do miss the adrenaline rush of a vaginal swab positive for Trichomonas.
STAT doesn’t mean much when every test is ordered STAT, does it? And if the test is ordered STAT, and the result comes back abnormal, it would be great if a doctor took the time to look at it, wouldn’t it? And diagnosing by checking off every stinking test on the req isn’t how they taught it in med school, I suspect.
Working in a lab can really shake your faith in doctors.
