As someone trained in Ireland, England and Canada and working in Canada for the past 18 years I am always shocked by the paternalistic notions expressed by clinical laboratory staff in the UK. It is really very insulting to patients, who after all are just me and you and our friends and families. Even though I can not stand the Sun, reading it does not make one incapable of understanding complex issues, especially as they relate to themself. More important is the fact that the only way to get someone to be involved in improving their outcome is to involve them in their own care. I always see complaints on this LIST serve from the laboratory specialists in the UK that no one will listen to them etc. Well did you ever think of having teaching sessions for the patients at the local clinics or a series of lectures aimed at the public in the evening at the hospital or tours of the laboratory with a short limited teaching session.. This sort of thing would at least allow laboratory professionals become visible. It might  involve good publicity from the local newspaper etc.

Elizabeth

Dear David

 

This topic will be considered at the Path IT Summit 17/18 Nov – an introductory paper I have written has been placed on the Path IT website – this will be a good forum to continue the dialogue. Please note its in the Darzi report too!

 

Regards

 

 

Gifford

 

Professor Gifford Batstone

MBBS, BSc, FRCPath, MSc

 

-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of David Hardy
Sent: 09 August 2008 17:35
To: [log in to unmask]
Subject: Re: Copy them in -- Richards 337 (43): a2324 -- BMJ

 

From my experience as a patient, I would say "no"; results are not routinely communicated (nor routinely any form of copied correspondence). That said, I recently had some routine blood tests through occupational health at work and I did get a copy of the results.

 

I think there are two issues here. Firstly, not all patients will want the results. Many (probably older) patients may still have a reverence for the medical profession that means they would rather just trust them to do right by them. Additionally we should be mindful that the average reading age in the UK is surprisingly low (I think it is about 12; The Sun sells many times as many copies as the broadsheets for this reason) - inconsiderately worded letters including the results may be harmful in some cases.

 

Secondly, the patient that trawls the internet for any and all information relating to their case, and then turns up in clinic arguing the toss, is not apocrypthal. A little knowledge is a dangerous thing, and may make the patient more difficult to relate to and treat.

 

I am not saying it shouldn't be done. I think in some cases it could be really useful and involve the patient more fully. In some cases, though, it could be disasterous. Perhaps the real question is not whether they should be given their results, but what will giving them the results achieve? The patient may be involved in their diagnosis and treatment, but they cannot "take ownership" of them; there is still an element of passivity in their situation. I am also a little unsure about the issue of educating patients this way. In terms of andragogy, adults learn when there is a reason to do so.

 

I would posit that patients should be given results and their interpretation on a selective basis.

 

Best wishes,

 

Dave

Dr David Hardy,
Senior Scientist,
Regulatory Clinical Pathology,
DSRD,
Pfizer Ltd,
Ramsgate Road,
Sandwich.
CT13 9EU
Tel: 01304 640619
E-mail: [log in to unmask]
or      [log in to unmask]

 

From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Jonathan Kay
Sent: 09 November 2008 16:49
To: [log in to unmask]
Subject: Copy them in -- Richards 337 (43): a2324 -- BMJ

http://www.bmj.com/cgi/content/full/337/nov04_3/a2324

 

And should we not go further than routinely copying patients into correspondence? Why not extend this courtesy to the results of blood tests and other investigations? It’s disquieting to have no idea when, or even if, your test results will be relayed back to you. Doctors should not assume that patientswon’t understand them or don’t need to know if the results are normal. Although it’s time consuming to relay results and discuss any uncertainties and dilemmas they may raise, it’s a great way to promote learning among patients.

 

I know this is commonly done in some other countries. Does anyone do this routinely in the UK? Or in some particular circumstances?

 

Should reports be different in content or format if copied to patients?

 

Jonathan

 

 

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------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/

------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. ACB Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/