Summary:
The diagnostic-to-treatment continuum is currently backward, with lab tests conducted after consultations, and a paradigm shift to perform tests upfront could improve clinical decision-making.
Takeaways:
- Current Practice: Lab tests are typically done after patient consultations, delaying the availability of critical data for decision-making.
- Proposed Change: Conduct lab tests during the initial part of the appointment to have results ready for immediate discussion and treatment planning.
- Potential Benefits: This shift could streamline the diagnostic process, enhance patient care, and highlight the importance of clinical laboratories in health management.
By Chris Wolski
Is the diagnostic-to-treatment continuum backward? If so, can we make a paradigm shift and turn it around? These have been the burning questions I’ve been pondering the last week or so.
The idea came up during an interview I did with Jeremy Stackawitz, the CEO of Senzo, for an upcoming edition of CLP’s Clinical Lab Chat podcast. It was just a brief point Stackawitz made near the end of the recording session, but it really struck me after I pushed the “stop” button. He really had a point. It was a “eureka” moment, for sure.
Why Is the Diagnostic-to-Treatment Continuum Wrong Way Round?
We all know how it works. We head into our primary care physician’s office, get weighed, have our blood pressure taken, get grilled about diet and exercise (at least that’s what my guy does), a few breathe in and breathe outs, etc., and then a nurse comes in and takes some blood work. Then we wait. For days.
Further Reading: Forgetting the Lab Has Consequences
Stackawitz pointed out how backward this is. Why have labwork done after the appointment? How productive can an appointment about our health be without the data needed to make recommendations upfront? With 70% of all health care decisions reliant on clinical lab tests, why wouldn’t we and our primary care physician meet after these tests were completed and the results were ready?
I have an excellent physician, and I do feel that we are partners in keeping me upright and breathing, but how much better would our appointments be if we had all the facts beforehand?
So, why is the diagnostic-to-treatment continuum the other way around? I suspect it’s a legacy of an age when we didn’t have all of the tests we have today. Decades ago, weight, blood pressure, open and say “ahh,” and all the basic observational tests were all a physician had to go on. It’s hard to break from the tried and true.
What Instead?
Stackawitz’s remedy to this inversion is simple—have bloodwork taken in the office and run it at the same time patients are being weighed and having their blood pressure measured.
With data in hand, what would follow is both a productive and immediate path to treatment and clinical decision making.
Laboratory Benefits
Certainly, the above scenario is the ideal—and it’s possible (and likely) not every primary care physician could implement an in-house laboratory environment even for simple tests. But if more could, the access to testing and compliance could make the diagnostic-to-treatment continuum a clear straight line.
It also would have the added effect of reminding patients and providers alike at every visit how key clinical laboratories are to keeping us healthy.
Chris Wolski is the chief editor of CLP.
