Behind the scenes in a Pathology Lab!

A pathology lab is usually always in frenzy. Samples coming in from Emergency, Outpatient Department, Inpatients and reports being signed out. The analyzers are in constant motion, quality checks, stat samples, routine samples. However, I may ask my technologists to slow down and not mistakes, they will be in a hurry to clear the orders.

However at times the VIP culture irks us.

The other day one of the high profile doctors raised a complaint.

The culture reports of his VVIP patients were delayed.

When I checked in, there was scant growth during first 24 hours. There was substantial growth when we checked the plates on Day 2 and after that further identification and sensitivity took another day. The reports were released sometimes on Day 3, though not exactly 72 hours. How I cursed the bacterium? Couldn’t it grow faster? Did it not know that it came from a VVIP patient!!!

I remember a few months before a doctor rebuked one of my technologists when she informed him about a Positive Mycobacterial culture.

“You are informing me at 3 weeks!” He shouted at the top of his voice. The technologist came in crying.

I couldn’t stop laughing. How do I remind that doctor that Mycobacterium was a slow grower took minimum 7 days to multiply.

Another VVIP patient the results were abnormal. The doctor called twice “Are you sure?”

Yes sir, we believe in equality. We use the same reagents on the same analyzer which are checked for Quality control each morning. We crosscheck each result before signing them off.

Who is responsible for all this at times I think?

The patient consumerism?

There was a time when Patient was a patient, a doctor was a doctor, and a hospital was a hospital. We doctors were poor at business skills. All we would do was open up our small clinics, see patients and be happy. Then came MBAs who looked at these clinics, and felt what rubbish? This doctor in such a small set up earns nicely. Let me build a hotel, hire a few doctors and nurses, and a lot many managers to mange everything else, and thus came the corporate hospitals.

Now the patient is a consumer, a doctor is another employee who once went to medical college and his schedule is being managed by n number of managers. A patient walks in, and is asked a hefty consultation fees at the counter, not because all goes to doctor, but because the bigger fish needs to fill in the coffers.

The patient thinks,”Ah, I paid so much, so now I want everything at priority.”

So everything becomes urgent.

The labs are forced to churn reports early because the consumer can’t come for a revisit, so he wants to finish all in one day. There was a time, when patients were allotted morning slot for sample collection, because fasting sample is the best sample for chemistries, many tests have a diurnal variation, and studies during day may show a false ebb or a peak.

I remember a concept being taught, ” Early morning Urine, or early morning sputum!”

The reason was that the sample was most concentrated, yet it todays consumerism, no one wants to understand the same.

Do share your experiences !! All the parties, management, doctors and consumers are welcome.

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