Labs has obligation to educate the public

Avoiding unnecessary lab tests

I refer to the report “MMA lauds law on labs” (Star July 2).

The Malaysian Medical Association(MMA) has every reason to applaud the Pathology Laboratory Bill which was passed recently to control pathology labs in the country. It fact this wise move is long overdue. If enforced properly, it will not only check the haphazard mushrooming of such labs throughout the country but would also ensure certain degree of quality of the results of the various tests offered.

It would go a long way to minimize the over commercialization of the medical investigations and in the long run benefit the patient by reducing the amount spent on these often unnecessary lab tests. In fact the cost of such tests is becoming increasing more exorbitant and beyond the means of many.

Many of these tests are really not necessary and are of little or no help in the diagnosis in those without any symptoms. In fact a false positive test may not only cause unnecessary alarm but also anxiety and confusion to an otherwise normal individual.

The most important aspects in the management of a patient is the clinical examination by a qualified and competent medical practitioner. The provisional diagnosis and plan of further action are based on this clinical examination. All investigations, like x-rays and laboratory tests are ordered based on this examination. The doctor should provide the patient with a logical plan of action to further investigate and derive at the diagnosis.

Patients must be educated to follow these time tested guidelines and not go straight for tests without the consultation of a doctor. It will not only be unwarranted and costly but occasionally detrimental if this important step in the management of a patient is bypassed.

Any experienced doctor will tell you that there is no single investigation that would clinch the diagnosis in the vast majority of patients. In fact all investigations act as guide and supplement the clinical examination to derive at a diagnosis. As doctors we are only too familiar how patients have been subjected to even major surgeries due to over-dependence on a particular positive test.

The pathological laboratories must adhere to certain ethical principles in providing services to the public. They have an obligation to educate the public on the actual facts and limitations of the various investigations they offer. They should refrain from exploiting the patients’ anxieties for the sake of monetary benefits.

Dr.Chris Anthony