Empowered patients, inadequate healthcare coverage, and systemic pressure are factors influencing doctors’ test orders and intensifying doctors’ collaboration with dwindling clinical laboratory staff.
A survey of 408 US physicians, conducted by YouGov analysis institute and commissioned by Siemens Healthineers, reveals how significant laboratory testing is to doctors’ clinical decisions and how reliant they are upon the support laboratory professionals provide.
Doctors have a robust clinical toolkit to inform patient care decisions, which includes laboratory testing. To what extent physicians use and rely upon laboratory testing, however, has historically been unclear. The data affirms physicians overwhelmingly agree (99%) that clinical lab testing is an integral part of the healthcare system and that the testing lab professionals perform for their patients helps them do their jobs better. Further, every doctor surveyed agrees lab results help streamline how they use other healthcare resources, for example, more efficient use of imaging and biopsy.
Evidence-based clinical guidelines remain a primary influence in determining what tests doctors order for patients (98%). These guidelines support physicians with standardized steps for informing clinical decisions. The survey suggests physicians may be increasing their reliance upon test results. While test results are to be interpreted in conjunction with patients’ medical history, clinical presentation, and other relevant findings, 98% of physicians agree they have modified a diagnosis or treatment plan based on lab test results, and 98% also agree that lab results have helped justify their clinical course of action.
Systemic Pressures, ‘Patient Agency’ Also Influencing Test Order Decisions
The survey also confirms systemic pressures are influencing their test order decisions. Inadequate healthcare coverage may prevent patients from getting the laboratory testing they need. While 67% of physicians say they do not have visibility into whether the tests they want to order are covered by their patient’s specific insurance, 60% of physicians with visibility into insurance or cost of tests (n=176) say cost of a lab test has led them to postpone tests they would have otherwise ordered.
While nearly one-third (32%) of physicians reported experiencing pressure to reduce their lab-test utilization, patient need and benefit are top-of-mind to inform physicians’ care decisions, as 95% agree that ordering tests to validate a patient’s care plan is their priority over conserving resources.
Also influencing their testing decisions is the growing dynamic of “patient agency,” the ability to act on healthcare choices and influence outcomes. For example, patients may arrive with their own research and expectations for testing, sometimes pressuring doctors to order investigative testing that may contradict doctors’ expertise or clinical guidelines.
Though clinical experience and evidence-based guidelines remain the foundation of their clinical decisions, the choices doctors make seem to also increasingly consider implications for patient satisfaction (ie, evaluation of care relative to expectations). In fact, 84% of physicians have ordered lab testing to satisfy a patient’s request, and 76% agree that patient requests have led them to weigh patient satisfaction against clinical judgment. These requests can add cost, stress, and delays, for example. Further, false positives can lead to additional clinical evidence gathering or more investigative steps that may or may not be covered by insurance.
The Pressure on Physicians Is Bleeding into the Lab
Healthcare professionals are under pressure. They must care for more patients, run more tests, and make faster care decisions with fewer staff and lower budgets. Though laboratory services account for merely 4% of hospital costs, the lab is a frequent target of cost-cutting measures, contributing to consolidation and outsourcing. Meanwhile, the implementation of automation-heavy “dark labs” has risen to help keep test results generating amid staffing shortages.
While 94% of physicians agree healthcare staffing shortages concern them, staffing shortages in the lab are felt more acutely. When labs are short-staffed, 96% agree it has a downstream effect on their patient care. With around 338,000 laboratory professionals currently practicing, it is the equivalent of one laboratory scientist for every 1,000 Americans. Clinical laboratory professionals validate and maintain more than 80,000 types of laboratory tests in use across US laboratories to help inform care decisions. Around 14 billion test results are produced for patients each year.
As test options for patients expand and the meaning of results for patients require more detailed interpretation, reliance on clinical laboratory professionals for guidance about how best to support their patients may be growing. While physicians indicate they feel supported by lab colleagues when they need guidance interpreting complex results (86%), more than half (55%) rely on the lab’s expertise to confirm which tests are clinically relevant for patients. Further supporting their interest in increasing collaboration, 96% are open to receiving feedback from labs to improve their test ordering practices.
“Physicians say clinical laboratory professionals are their essential partners in delivering high-quality patient care,” says Dirk Heckel, chief technology officer for diagnostics at Siemens Healthineers, in a release. “A diminishing laboratory workforce threatens the collaboration doctors rely on for clinical clarity. Among the opportunities to make sure physicians receive valuable clinical consultations they rely on, and patients have access to testing advancements for their care, we can strengthen the lab with technology that enables lab professionals to focus less on manual, repetitive testing tasks.”
Siemens Healthineers revealed the survey findings today at the ADLM Annual Meeting in Chicago. The survey report, Decoding Doctors’ Decisions: How System Friction and Patient Agency Affect Physicians—And What This Means for Lab Testing, is available here.
ID 3523606 © Jill Battaglia | Dreamstime.com
