Many patients are reluctant to get laboratory tests done that have been ordered by their healthcare provider. There are several reasons for this, including concerns and misunderstandings.
- Fear of the discomfort of needle sticks.
- Not understanding why the tests are necessary or what these tests will reveal (“Why can’t the physician just examine me and listen to my problems? Isn’t this enough?”).
- Fear that specific tests are actually drug tests in disguise and may turn up information that may ultimately hurt the patient, e.g., if they get into the hands of law enforcement.
- Feeling that they have already had some of these tests. Why repeat them?
- Fear that lab tests will add to medical bills.
Let me address each of these individually.
Fear of needle sticks
Unfortunately, many tests require a sample of blood and thus also require a needle poke. Except for particular instances (e.g., the patient has an indwelling blood vessel port) a needle stick is unavoidable. However, there are things to minimize the pain of such needle sticks. You can go to a laboratory that has a lot of experience with taking blood (most large practices or contracted large laboratories such as Quest Labs, are set up this way). If you are someone with small veins or who has had difficulty giving blood samples in the past, you can mention this to the laboratory personnel, and they may be able to find their most experienced person to handle you with minimal discomfort. Finally, some labs don’t require needle sticks (e.g., throat swabs for strep throat screening, or urine tests).
Are these tests necessary?
Why can’t the physician just examine me? There are several conditions (e.g., anemia = low red blood cell counts) that the physician cannot determine only by examining you. In the case of anemia, this is particularly the case in people of color since they don’t display the same pallor that white individuals show, and this only shows in such individuals if the anemia is very severe. Other measures, such as for kidney function, blood glucose, or antibodies that may reveal an infection, can only be determined with blood and/or urine tests. Therefore, in order to get a complete assessment of your condition(s), blood tests are often needed.
Fear that certain tests are actually drug tests in disguise
It is your right as a patient to be told what each test is for, including any drug testing. This should not be hidden from the patient. Also, understand that most urine tests are not drug screens but rather an analysis of kidney function or looking for possible urine infections, which may be severe. If your provider does request a drug test, they should be explicit with you that this is what they are doing. Finally, the results of such tests still fall under the HIPAA (Health Insurance Portability and Accountability Act) laws and should always be kept confidential along with the rest of your medical information. They should not be given to law enforcement or to other agencies without your consent.
Why are some tests repeated?
Depending on the condition, some tests are not only for diagnosis (for example, an elevated blood sugar level to diagnose diabetes) but also to monitor the success or failure of subsequent treatments for this disorder. For example, with appropriate medication, blood sugar elevations should become less over time. Otherwise, the treatment needs to be changed. Your healthcare provider will determine how frequently such tests should be done and should explain this to you. If this does not happen, we can help.
Lab tests will add to my medical bills: Most of the lab tests ordered should be fully covered by your insurance plans, and you should have no co-pays or subsequent bills. In rare cases, a particular analysis may not be covered by your insurance, but in such instances, your healthcare provider should tell you this beforehand, and what the cost is likely to be. You can also ask your provider about such costs. Overall, getting your lab tests done when asked (either right after your clinic visit or some a short time before your next clinic visit) is fundamental and will greatly enhance the care you get. By contrast, if your healthcare provider doesn’t have the laboratory test results by the time of the next visit, then the provider is limited in what they can do for you and may have to ask you to come for yet another clinic visit, this time after you have had your labs done. Your provider should also promptly give you the results of these lab tests and explain what they mean. Often you can get the results soon by signing onto your clinic’s Patient Portal (linked with your electronic medical record). If you have difficulty understanding what the labs mean, we can help.
By David Gordon, M.D.
April 25, 2020
Keywords: laboratory test, labs, anemia, blood, urine, bacterial culture, fungal culture, virus tests, drug test, infection, HIPAA, cost