Practicality and Efficency in Clinical Medicine

Often times, patients are subjected to inappropriate clinical laboratory testing. But the real purpose of clinical laboratory testing is to CONFIRM a clinical impression, and laboratory testing should not be the sole basis of FORMING a clinical impression.

Thus, appropriate clinical laboratory testing should be guided by the following:

1. A clinical impression after an interview with the patient

a. If patient doesn’t have symptoms, signs, or risk factors for illness or disease, then  clinical laboratory testing is NOT in order

b. If a patient has symptoms and signs of illness or disease, then the organ system (s) in disease should be determined and a selection of general labs to confirm the organ system (s) in disease should be carried out by consulting with a laboratory medicine specialist.  Specific or highly specialized laboratory testing should NOT be carried out.

c. If a patient has risk factors for illness or disease, then scheduled surveillance for select diseases or illnesses associated with those risk factors should be done, and select clinical laboratory testing may be in order. Such risk factors that may or may not be associated with symptoms include obesity, diabetes, high blood pressure, HIV, tobacco abuse, sexual promiscuity, age related disease/illness, etc.

2. Management of CONFIRMED diseases or illnesses should guide proper surveillance as determined by Guideline-Standards provided by National and International Health Authorities

Consulting the Laboratory Medicine Expert

References:

American Journal of Clinical Pathologists 2011;135:11-12

American Journal of Clinical Pathologists 2000; 113: 336-342

We at MDC Atlanta are committed to informing our patients for better quality and safe, as well as affordable health care.