Clinical laboratory issues in diagnostic testing - recent Milwaukee Sentinel investigation

Vic Nicholls nichollsvi2 at GMAIL.COM
Sun Jul 12 19:59:34 UTC 2015


Thanks to the wonderful people at the AACC and labtestsonline, I can 
sort of figure out with pretty good accuracy * what tests can be done.

That's why I am a huge believer in working together. That's what 
patients and doctors do to help eliminate issues/problems in 
communication and diagnoses. They might see more regular patients but 
its "zebras" like me that get you.

I wouldn't expect docs to listen to me carp on my salary but if I'm 
saying I'm weak and dizzy and throwing up, or I have pain, yes I would.

Vic




I have had at least one doctor ask me if I have an MD, medical 
education, etc.
I have had at least one doctor tell me she's really getting this 
(referring to the medical research I present)
I have had at least one doctor request to review my sources (and I give 
them because its my job to help my physicians and out of respect for the 
tough job they do every day)
My sources are their sources
I have had more than one doctor upset because I caught some of their 
mistakes or things they didn't know (no one can know everything, there 
are some reasonable things one should know but otherwise, seriously ... 
you're a human not a computer medical database)

On 7/12/2015 3:04 PM, Ross Koppel wrote:
> Well, the same is true if you take your car to the mechanic.
>     When it comes to medicine,  I am not an MD and don't know what 
> tests to most beneficially order or the range of diagnostic 
> considerations that someone trained in medicine will/should/does 
> consider.  I'm not a total idiot about cars or bodies, but I don't 
> spend my life caring for either.  Even if you consider that 30% to 40% 
> of the _very initial _Dx are wrong (goes down dramatically as stuff 
> gets known), it's still probably better than my less informed 
> hypotheses.   Sure, I've guessed better sometimes than my doc.  Sure, 
> he's been wrong or misdirected.  But he sees a lot more sick folk per 
> hour than do I, and he knows more about the human body than do I.
>     Should the doc listen to the patient?  Of course. Do they do that 
> enough?  No.   But if I want to feel listened to, I talk with my dog, 
> who is very patient, does not interrupt, and is not struggling with an 
> EHR or an insurance rep seeking to deny coverage to everyone.  On the 
> other hand, the dog's solution to all problems is to run and eat.  I 
> do both; the first has been helpful, the latter far less so.
>
>
> Ross Koppel, Ph.D. FACMI Sociology Dept and Sch. of Medicine Senior 
> Fellow, LDI, Wharton University of Pennsylvania, Phila, PA 19104-6299 
> 215 576 8221 C: 215 518 0134
> On 7/12/2015 2:01 PM, Peggy Zuckerman wrote:
>> In my patient world, where I am alternately asked to be proactive 
>> about my health and then to trust the doctor implicitly, not even 
>> being guaranteed access to my own records, I see these errors as 
>> deriving from the physician.  He determines which test I may need, he 
>> sends me to get the labs, tells me not to call as only problems will 
>> be relayed to me by a nurse/clerical worker, and makes his treatment 
>> recommendations upon those results.
>>
>> If there is an error from the lab or in the reporting of those 
>> results, or even in the choice of the test or the laboratory, from 
>> the patient's point of view, it is the responsibility of the doctor.  
>> Of course, this is the same for imaging, the type thereof, the body 
>> parts imagined, the results interpreted, etc.  This is not fair, but 
>> is the reality.
>>
>> Peggy Zuckerman
>>
>>
>> Peggy Zuckerman
>> www.peggyRCC.com <http://www.peggyRCC.com>
>>
>> On Sun, Jul 12, 2015 at 7:59 AM, Robert Bell 
>> <0000000296e45ec4-dmarc-request at list.improvediagnosis.org 
>> <mailto:0000000296e45ec4-dmarc-request at list.improvediagnosis.org>> wrote:
>>
>>     Does this make focussing on errors in medicine superfluous?
>>     Should we not try to sort out the basics first?
>>
>>     Robert Bell
>>
>>
>>
>>
>>
>>     Sent from my iPad
>>
>>     On Jul 12, 2015, at 6:50 AM, David Meyers <dm0015 at COMCAST.NET
>>     <mailto:dm0015 at COMCAST.NET>> wrote:
>>
>>>     http://www.jsonline.com/watchdog/watchdogreports/weak-oversight-allows-lab-failures-to-put-patients-at-risk-303445851.html
>>>
>>>     David L Meyers, MD FACEP
>>>     Listserv Moderator
>>>     Society to Improve Diagnosis in Medicine
>>>
>>>
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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