Manor Field Blog number 10 – blood and other tests

We do a lot of blood tests, us doctors; nurses and others are also to blame, but mostly doctors.

I cannot imagine how many blood tests are taken across the country every day.

In a medium-sized surgery like Manor Field, we receive approximately 100-odd different investigation results daily; not all are for blood tests although they are the majority (others are urine, sputum, faeces, cervical smears and the like).

What strikes me is, the extent to which people understand about the tests they are undergoing.

Sometimes someone will ask, ‘What is my cholesterol?’ Yet, more often than not, these are something left for the doctor to interpret (and know).

My brother who lives in Israel receives an annual PDF of his blood and urine tests, which he passes to me for analysis. I don’t know if this form of empowerment makes any different to him or how he relates to his health or wellbeing.

It is generally accepted that patient participation in the process of care results in better outcomes than the old passive/paternal model that used to exist, yet, how far have some of us come?

Does anyone know their haemoglobin or creatinine level?

Does it matter or make any difference if they do or don’t?

I’d suggest, it probably is not relevant for the majority; after all, most of the population are well, if not completely healthy. In general practice, I’d say that at least 70 per cent of blood tests are completely normal (mostly those done for routine, annual screening), 20 per cent are a little off and the remainder have something wrong that needs action.

The relative proportions in hospital are likely something like 50 (normal), 20 (normal, but a little off) and 30 (abnormal), in other words, most of the blood tests taken in A&E for example are normal; this is part of the process of making sure that nothing is wrong; no heart attack, blood clot or infection.

Just to mention – a normal blood test does not mean that there is nothing seriously wrong – this part is the ‘art’ of the clinician.

Knowing your blood tests at this time (when you are acutely unwell, with say pneumonia) is probably not that helpful although in some circumstances I imagine it will empower people.

I guess the point of this blog is to ask people whether they would like to know their results? I don’t see any harm in a person knowing this; after all, it is their blood (or urine or spit) that is being analysed.

As to what you do with the information is another matter.

There is a risk that the inverse care law would apply (something I was reminded-of in Dr O’Mahony’s book) – that is, those who need to know their blood results the most (those with the worst health) are likely to be those least likely to make enquiries or understand what it is about.

I am more sanguine than my Irish colleague and believe that this could form part of a future relationship with patients – that and a general understanding of the different conditions they have and treatments they receive.

Passivity can never be good.

An entirely separate issue is whether doctors, nurses, pharmacists and others would have the time to spend explaining to patients what is what, and that would be a concern although overall it might save time.

What I will do, therefore, in future blogs, is, leave it to my readers to ask me what they would like to know. (Otherwise I will go on writing what I want which might not be what people want, I am after all a little biased).

(If you want to email me that is fine too – rodkersh1948@gmail.com)

I can’t profess to know everything about health and care although I will do my best to find-out – it might even do me some good! I already have a request for more information on Aspirin; send-in your queries and I will try to answer.

If this blog is to have any impact, please share with family, friends and colleagues and ask them to share too.

If I get inundated, I will let you know.

Here to the revolution!