Over-investigation by doctors?

Someone close to me has been given two blood tests in the space of nine days, ie Feb 1 and Feb 9. The doctor who ordered the tests is a senior consultant. I won’t name the doctor’s speciality or the hospital involved: as I don’t know if the tests are necessary, as  I’m no medical specialist.

However, as a lay person, I’m astounded.

Let me explain.

The first series of tests involved CA-153; Renal Panel (Na, K, Creatinine); Calcium & Albumin and Full Blood Count (Hemogram, DC, Platelet).

Cost: $121.15

The second series of tests carried out today, Feb 9, involved Folate, Iron, Transferin, Vitamin B12 and Full Blood Count (Hemogram, DC, Platelet).

Cost: $109.60.

The patient isn’t in hospital nor has the patient any new complaints other than existing conditions.

The first series of tests were done before seeing the doctor and the second series on seeing the doctor today.

There is suspicion that the patient might be anaemic but won’t doing two blood tests so close together in fact confirm the suspicion by biasing the result? 

If any medical person, or someone who knows something about medicine, reading this could enlighten me either by email at lucy1808@yahoo.com or leaving me a comment in this post, I would be most grateful.

I don’t want to live with the perception, perhaps misplaced, that the doctor had over-investigated, thus raising medical expenses needlessly.

I would like to be shown that I’m wrong.

So, can someone please help?

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2 thoughts on “Over-investigation by doctors?

  1. One is never going to be able to comment accurately without any details of patient’s medical history/problem and what took place in consultation.

    However what i can tell u that this is the problem with doing blood tests BEFORE seeing the doctor – routine tests, or what is thought o be expected – are ordered. And then after the consultation, it is found that more investigations are required, so more are ordered. And then patients/lay people think they are being over investigated.

    The first batch are usual things for the patient’s existing problems so fair enough. The second batch are to look for the type of anaemia she has – whether it is related to low iron/folate/b12 – transferrin and ferritin are related to iron defiency anaemia and are in most good labs nowadays also tested in conjunction with the rest. In the UK we call this panel haematinics. If one is investigating anaemia, it is what should be ordered, hence I would not classify it as unnecessary.

    As to why the full blood count was repeated – the only clinical indicator to repeat it in such a short while is if the patient is bleeding actively, and the haemoglobin needs to be monitored. Am not myself aware of any other indications to repeat it in such a short time.

    Hope it answers some of your queries.

  2. Hi Areya: thanks for taking the time to answer so thoroughly. All the more appreciatied because I know how tied up you are with your relocation etc

    Off-site I have received this email which is more or less parallel to what you’ve said, and you both have raised a small question mark over the full-blood count test. No, the patient hasn’t been bleeding/isn’t bleeding, profusely or otherwise. Nor is the patient tired etc

    Anyway, for yours and others’ information, this is what the eml to me said:

    “Blood tests are generally used to confirm clinical suspicion or as a screening tool. It would appear that the first series showed the patient had anemia. The second series looks intended to find out the cause of the anemia ie whether there is deficiency of one of the key elements needed for production of haemoglobin. However, why then a repeat full blood count so soon. The reason is usually when the first results are unexpected or has gone awry in some way. So a repeat is to make doubly sure.”

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