PSA: hospital laboratories are not staffed with doctors

[magical thyme]

they are staffed by lab assistants (who occasionally answer phones, do paperwork, and, oh yeah, phlebotomy)

and lab tech(s) (who occasionally answer phones, run lab tests, maintain analyzers and instruments, and reluctantly phlebotomy when noone else is available)

We do not diagnose. We do not prescribe. WE ARE NOT ALLOWED, UNDER HIPAA LAWS, TO GIVE RESULTS TO ANYBODY EXCEPT APPROPRIATE DOCTORS AND NURSES.

So please don't call a lab tech and try to wheedle results or a diagnosis or a prescription when your doctor isn't returning your calls. And please don't suck up our time and energy in the mistaken belief that if you go on and on about your green snots, that we'll somehow breakdown and jeopardize our careers by giving you results. We process green snots, red pee, red poop, etc. all the time; we are not impressed.

If your doctor isn't available to you and you're getting so much worse that you can't wait until Monday, then go to the urgent care center or to the emergency room. The doctors and nurses there can help you. We cannot.

What we are in a small hospital or urgent care is often the only tech running the entire lab with a busy ED. When you prevent us from doing our job by trying to get us to do what you have admitted you know we cannot do, you are not helping yourself, or us, or any of the ED patients with severe abdominal pain, chest pain, etc.

[In_The_Wind]

1. So

Visiting the lab with a basket of freshly bakes muffins won't shake loose any info. Darn!

[magical thyme]

2. not if the info you are looking for is protected patient info

or it may work, if the person involved doesn't care if they get fired. But every computer access to info is tracked and recorded, and the records are randomly searched. If they see somebody accessed data they had no legit reason to look at, they done.

We had a registration person walked out the door by security a couple years ago without warning or notice. Our best guess was she must have accessed info and gotten caught. The only thing we could think of where there'd be no warning, no questioning, no review. Just walked straight out the door one day.

Someone drove me nuts with this yesterday. I couldn't figure out what she wanted from me. I'm not a psychotherapist either, so if you're just looking for somebody to be sympathetic, don't call me when I'm on the job. Especially when the effing chemistry analyzer is acting up and a common test that every ED patient gets refuses to pass QC.

[still_one]

3. What folks may not realize is at least by California law, patients are entitled to obtain a copy of

their Medical Records. So, if they are not able to obtain those results from their doctor, they can request them through the Medical Records department.

In addition, the physician's nurse, or even another physician can obtain those results for you.

As for your statement don't bother the clinical lab, there are appropriate times where the patient has every right to contact the lab. To find out how to a specimen needs to be collected, and to discuss methodology of the tests being performed, and what activities can affect the results of those tests.

Also, if an abnormal result occurs that can be life-threatening, it is the labs responsibility to make sure that the ordering physician and the nurse realize this as soon as the results are available, even if they did not order it as STAT. To not do so may NOT be illegal, but it would be highly irresponsible.

[magical thyme]

5. our policy is to contact the physician with critical result(s)

if we are unable to reach the physician (say, the person is a tourist), then we will track down the patient. (Difficult when they are tourists -- I've had to leave messages at hotel desks asking them to report to our ED asap).

[still_one]

6. Of course.

[magical thyme]

10. also in the case that inspired my little rant...

I explained, in response to her direct questions, that we don't result that test in our lab, it goes to our reference lab. There are 2 shipments/day. If it's in time for the morning shipment, we pack it up and ship immediately. Otherwise, we incubate it until the evening shipment. That it needs to be incubated for 48 hours before it can be resulted. That if the specimen was collected on the day she remembered, in all likelihood it was not yet resulted (early morning), but would be by the end of the day.

That if her doctor wasn't available and she couldn't get an appointment that day, and she felt it couldn't wait, she had the option of coming into the Urgent Care center.


I could understand her being upset that her symptoms are worse and that she couldn't reach her doctor. But if you think you're seriously ill, then take yourself to your Urgent Care center or ED.

[still_one]

19. I am surprised that the place allows patients to contact the technologist directly

Regardless, you're advice is correct. When I was a clinical chemist I had to deal with irate doctors, but not patients. I was wondering what happened to you

[magical thyme]

20. anybody can call the lab, unfortunately

they don't often, fortunately. I've actually picked up and had sales people trying to sell me magazine subscriptions.

The assistant was finishing up with a patient, so I picked up the phone. Gaah. I was already having a terrible morning because one common chemistry rx absolutely would not pass qc. re-cal -- nope. mixed fresh calibrator. nope. thawed fresh qc. nope. replaced the rx and it went from level 2 at 2-3 SDs below to levels 1 & 2 2 SDs too high. I ended up confirming all the stats on the istat and sent the routinesto the sister hospital for that test.

I can't retire soon enough.

[still_one]

23. I really empathize with you regarding the QC issues, and recalibration of controls etc. I have no

Doubt you had a very long day

Hang in there

[frazzled]

8. All our lab results are posted to a secure website

to which we, as patients, have access. (I don't know that this is law in Illinois, but it is the practice of the medical group we use, which is connected to a major hospital.)

You are sent an email telling you that new test results are available, and you can log in to see them. This is usually good, especially for things like standard blood tests, but recently we found it a bit unsettling. Mr. frazzled has had a series of PET scans over the last months. On previous occasions we were simply sent an email that the results had been sent to our doctor. It's not really something you should read before your doctor discusses and explains to you; it then appears on your chart after that. However, we just got sent the results of the most recent PET scan in advance of the doctor's appointment, and I wish we hadn't looked at it. It sounds scarier than perhaps it is, and the terminology in the long, written report is not something a layperson can understand very well, even with the aid of the Internet. I truly wish we hadn't opened it, and I've tried to just put it out of my mind for the weekend.

[magical thyme]

13. the risk of too much and not enough info, simultaneously

I'm in a tiny rural hospital system and we don't have anything so sophisticated.

Most hospitals I know of require that patients give signed consent to obtain their medical records from the medical records department. That may be specific to my state, though, I don't know...

[still_one]

14. Most of the modern facilities do that, however, usually those results need to first be reviewed by

the physician or nurse before they release them to the computer for patient viewing.

For imagining results it depends, but usually you can see the radiologists report once the physician releases it.

The copy of the actual images are usually not released unless you go through Medical Records.

I personally believe the patient is entitled to see any result from any test performed

Of course if a patient does not want to see those results that is the patient's rights.

Let me give you an example where it might prove to be helpful, even though intimidating for some. The patient receives the imaging results, becomes alarmed at the interpretation, what will the patient do? Call their doctor for a consult or an appointment. That is a good thing.

Now let's take the other side. Suppose the imaging is done, but the results are not conveyed to the patient. The patient may assume because the physician hasn't contacted him that everything is alright, and that is not necessarily the case. Sometimes things do fall between the cracks.

[nolabels]

4. After being a professional mechanic for 38 years i can tell you the medical field has a......

big comeuppance coming. Most other things in daily life seem to be getting easier to access and understand. A lot of the people who operate in medical field seem to want to take things the other way. When I have medical issues for me or others i know i investigate on the problem on the internet (and find most of the answers) as much as possible and figure out what the doctors should be saying long before i get there. Then if i find the visit problematic with the doctor i investigate things even more.

[magical thyme]

7. Test results are between you and your doctor. Symptoms, diagnosis and prescription are between you

and your doctor. If your are not satisfied with your doctor, find a different doctor. If your doctor is not available and your symptoms get worse, then you need to go to an urgent care center or ED.

I'm a lab tech, not a doctor. It's not that I don't want to help you know the results. It's not that I'm trying to make things problematic for you. It's that I would be breaking the law. I would lose my job; the hospital/urgent care center, etc. could be heavily fined for violating HIPAA.

We even have to be careful how we phrase things when we write up certain results. For example, a lab tech I work with found the first case of babiosis in our hospital a couple years ago. She couldn't report it as babesia or babesiosis because that would give the appearance of diagnosing. We didn't have a protocol, so she consulted with our lab manager and resulted it as "intra- and extra-cellular ring forms" to avoid the appearance of diagnosing, even though we all knew from what we could see on the slide that it was babesia and the patient had babesiosis.

[still_one]

15. I think you mean "if you are NOT satisfied with you doctor" in your first sentence in the body

[magical thyme]

16. oops. thanks. corrected. nt

[nolabels]

21. I checked up on that 'babiosis' stuff, that is interesting

We are all afflicted with this thing they call the Human body, and eventually it give up on us in one way or another.

In a kind of somewhat similar situation my stepson almost lost his job because of telling me something i wasn't supposed to know. I was getting a crown on my tooth done and the permanent crown that needed made just that happened to be sent to the Dental lab where my son works. It's long drawn out procedure on how they make them but when his buddy at the job he informed my son he was doing the job and the dentist was slightly incorrect in the grind that was put the tooth for mount after that i then got to find out about it by my son. Who does the same work but just didn't get that job assigned to him

Then to complicate all these things, the receptionist at the dentist office had wrote the wrong day my appointment card for my return visit and i didn't check it out prior to that. When i showed up that day at the office i was a little huffed that i wasn't supposed to be there yet, but took in stride mostly. Anyway i thought, at first when i showed up at the office and them not being ready there must have been an issue with lab not getting the crown done because of what the doctor had done with the grind making it difficult produce. So i blurted that information out to the receptionist, which i didn't know was confidential. Then as a result a lot of phone calls were made and my son had a real go around with the lab he worked for because of it. He still works there four years later though

I dumped that dentist office after that and now to go to one that's a lot closer and where they make the crowns on premise on a expensive cad/cam machine in about a day.

[still_one]

17. I disagree with your assessment. The medical field has made it much easier to obtain your results.

As I said previously, most states allow patients a copy of their Medical Records.

http://www.healthinfolaw.org/comparative-analysis/individual-access-medical-records-50-state-comparison

Most of this is governed through HIPPA. This not only protects the patients data, but allows the patient to access that data

[nolabels]

18. Maybe it's just the particular doctors that were assigned to my 86 yr old mom and 77 yr old friend

or the doctors i pick on my PPO. But as of late it's more miss by all of them. My mother just got carted of in an ambulance last week and spent two days in the hospital. I help her out as much as possible and live just next door but in the afternoon i go to my job. How it happened is her grandson just happened to be visiting on rare occasion and found her knocked on the floor, got her up but she was not well. Anyway the abbreviated story is a cardiologist that her primary doctor referred her too for blood pressure issues gave her a new prescription that did this to her. Then after she gets out of the hospital i tried to do a follow up appointment with either of her doctors and they both on vacation so she is going to have to wait till August to see one of them. The Cardiologist doctor assured me there would be no major side effect to worry about with the new medications but she just took it only once and ended up in the hospital two days later and this is the kind of stuff that happens. Do i trust doctors much, hell no.

I actually have many horror stories that i have acquired through the years and if I needed some more, my sister who is a retired RN, who lives on the east coast, could give me thousands. Let's just say i have a personal kind of bias because i have been getting the short end of the stick to view things from too many times in the last few years. My advise to anyone is do a lot reading and if can you avoid the medical professions within reason, do so, because it seems to me that it's just a roll of the dice.

[still_one]

22. Wow, you have had your challenges. Unfortunately today one has to be very pro active

and not assume everything will be caught

All the best to you and you family

[Orrex]

9. It hurts when I raise my arm like this.

[magical thyme]

11. then don't raise your arm like this.

[Orrex]

12. And you say you're not a doctor!