Shirah Vollmer MD

The Musings of Dr. Vollmer

Lab Rant

Posted by Dr. Vollmer on April 6, 2015

Ordering laboratory tests is an important part of my work as a physician. I prescribe drugs which require laboratory monitoring and as such, blood work is important for some of my patients. I write an order. The patient takes it to their lab of choice and results are sent to me. When it is urgent, I tell the lab, and results are given to me promptly. Sounds simple? Well, not so much. As the wheels of payment changes, as patients and physicians are being forced into specific ecosystems, the flexibility is lacking if a patient or a physician is not part of a larger group. Like a PC user who feels foreign in an IOS environment, so a patient that gets most of his healthcare at UCLA will have trouble integrating his medical record if he also goes to Cedars. Example. A patient needed a stat or urgent lab. I called the lab and they said that since I did not have a physician member number, they could do the lab, but they could not do it stat. “Isn’t that unethical?” I asked, wondering how the laboratory has the right to refuse a physician’s order. I got the repetitive answer that I had to sign up with that lab in order to get the blood result quickly. There are politics here, and payment streams and consumer manipulation, all of which I am not clear about, but a laboratory telling me that they refuse to do a stat lab because I am not a frequent flier, just seems wrong. Rant complete.

2 Responses to “Lab Rant”

  1. Shelly said

    How do you get a physician member number? Wouldn’t it be wonderful if there were a centralized system whereby you could sign up once and become a member of all nearby hospitals? Do you have to sign up individually to say, Cedars, UCLA, USC, Northridge, St. Josephs, etc…, all separately? What is the difference in the number of days between a “regular” test and “stat?” Do you have to pay to become a member?

    • I do not know. I have to learn more about this new world of medical ecosystems. Yes, centralization would solve a lot of problems. A regular tests comes back in 1-3 days, whereas a stat order comes that same day. The pay to play question is interesting. I don’t think so, but that may be true one day. Thanks.

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