Consumer-driven lab testing eyed at TMH
December 17, 2009
The Memorial Hospital is in the process of implementing a new plan that could help patients take some aspects of health care into their own hands.
Consumer-driven lab testing would allow people to go to the TMH laboratory and order any of several tests without a referral from a primary care doctor.
Results go directly back to patients.
Kristine Cooper, TMH laboratory manager, said the program would make it easier for people to monitor their health.
"This is wellness-based; it's not super diagnostic," Cooper said. "You're not going to get a test back here that's going to tell you that you have six months to live or anything."
The limited menu of available tests would include routine checks such as blood type tests, thyroid activity, cholesterol, iron levels and pregnancy tests.
Currently, patients have to see a doctor and get a referral to take one of these tests, which Cooper said adds time and cost to simple procedures.
The most expensive item on the list is a urine drug test for $55 that Cooper said parents could use to keep track of their children's actions without having to go through a doctor.
The program would increase revenue for TMH, she added, but is primarily to drive a better wellness program in the community. The availability of information through the Internet has made average people more involved and active in their own health issues.
"I do think that the consumer is a lot more educated," Cooper said. "The doctors have their degree, but you don't want to take away from the fact that there are intelligent people that can do research and learn some things about their health. Still, they don't have a medical degree. But people can take the results in their hands and take them right to their doctor."
Talk of implementing the new program have met with some resistance from clinicians in the community.
"There has been lots of pushback," she said. "We've had some very negative feelings from some of our medical staff. I think the general mentality is that something's being taken out their control, maybe."
Dr. Pamela Kinder sees patients at the Kinder Family Clinic and is one of the Craig doctors who sees the potential for problems with consumer-driven lab testing.
She said lab tests are primarily used for diagnostic purposes and should be tracked by physicians.
There are many factors that go into the interpretation of lab results, Kinder said, and if the results are handed directly to the patient and not done through their primary physician, some complications can be overlooked.
"I think the hospital's just responding to patient demand," Kinder said. "A lot of people, they see something on the Internet and they think, 'Oh I have a family history, oh, I just want to check it.' But that's where concern is. The labs need to be interpreted in the light of family history and symptoms."
Kinder said some people on cholesterol medication might want the option to monitor their own cholesterol levels.
However, some people on cholesterol medications are at risk for liver problems and might need to have liver enzymes checked, as well.
"I guess the bottom line is tracking," she said. "If we initiate a lab order from our office, we track that to make sure we get the results, and we may or may not change medication because of it."
She said many doctors in the community are concerned that it will affect medical care but that if people do end up choosing to get their own tests, she urged them to take their results to a primary care doctor.
She said the main concern is that people will get results back and either overreact about an abnormal test or under-react if a problem is hidden in the results.
"Most of us are pretty reluctant, but we recognize that it's a service that people may want," Kinder said.
Cooper said the program will not replace doctors' relevance as diagnosticians but will be wellness-based.
She said there is no need to cut doctors out of their current role.
"I see my doctor on a regular basis, and I think that is important," Cooper said. "But it's also important for people to feel they have ownership in their health."