Conducted by the American Society for Clinical Pathology (ASCP), the survey found two-thirds of patients expect results within a day when the test involves a serious illness – such as a cancer biopsy or liver disease. And even when the results are routine, such as a check of cholesterol levels, more than 40 percent expect them that quickly.
In reality, results often take longer to be sure they are correct, to allow time for complicated and extensive processing and to give priority to tests that may have an immediate impact on treatment. Additionally, the shortage of lab professionals is a problem that will only worsen as baby boomers age and increasing numbers of tests are ordered.
What’s a Normal Wait Time?
“It’s reasonable to expect most test results within a week, and they may be able to be completed sooner, depending on the circumstances,” said David Glenn, MASCP, MLS (ASCP)CM , CEO, Pathology Services, P.C., North Platte, Neb. and chair of the ASCP communications committee. “There are multiple factors that affect how soon test results are available to patients. For example, a blood test for PSA screening (for prostate cancer) or cholesterol requires less time to process and analyze than tissue or cell samples, such as a Pap test (for cervical cancer), that must be specially prepared before the slides can be reviewed by medical lab professionals. Most people don’t realize that an average Pap slide contains tens of thousands of cells, and the lab specialist is required to look at every cell. That takes time.”
Glenn advises patients to ask their doctors the following questions about their laboratory tests:
* What tests are you ordering?
* What will they tell you about my health?
* When will I know the results?
* Should I call you for the results, or will you call me?
“If it’s been a week, and you were told you would have results by then, call the doctor’s office,” he said.
Why the Wait
Factors that affect how soon test results are available to patients include:
* Laws that Protect Patients. To help safeguard against inaccuracies, federal legislation known as the Clinical Laboratory Improvement Amendments (CLIA) sets standards for laboratories to assure the testing is being performed accurately. CLIA even limits the number of Pap slides that can be read in one day by a cytotechnologist (a specially trained lab professional who examines cells for early signs of cancer and other diseases).
* Complexity of the Test. In some cases, numerous time-consuming steps must be performed to complete the test. For example, analyzing a mole for cancer involves a multiple-step process that takes time: the removed mole sample must be fixed in a preservative, embedded in a type of wax, cut into extremely thin slices, placed on slides, stained and examined under a microscope by a pathologist (a medical doctor with an advanced specialty in laboratory medicine). Sometimes special stains or further studies are required to make the diagnosis, adding more time before a report can be completed. Even a simple test such as for strep throat or a urinary tract infection requires time to have the specimen placed in a substance that allows bacteria or other microorganisms present to grow to a level that can be seen, separate the different organisms and test them to see if they are causing disease. If they are, further test must be done to see what medications will be effective.
* Impact on Treatment. Tests that may have an immediate impact on the patient’s care will be ordered by the physician as a priority and are processed first in the laboratory. For example, an emergency room patient who appears to be in a diabetic coma will have a glucose test ordered immediately and results will be available within a few minutes so the appropriate treatment can be given as soon as possible. When routine, non-urgent testing is ordered, it is processed by lab professionals along with their normal workload.
* Whether the test results are normal or abnormal. Pap slides that show abnormal or suspicious cells will take longer because they require additional study, including close review by a pathologist. In addition to reviewing these tests, a pathologist also must review a percentage of normal Pap tests to ensure continual accuracy, according to CLIA regulations.
Shortage of Lab Professionals May Add to Wait Time
The lab science profession is experiencing a workforce shortage, while the demand for tests is increasing. “The aging of the population has led to a growing number of lab tests and ASCP is concerned that the current shortage of lab professionals may make it difficult to meet the public’s demand for prompt results,” said John E. Tomaszewski, MD, FASCP, president of ASCP and professor and interim chair of the Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia. Lab tests are involved in more than 70 percent of medical decisions.
According to the U.S. Department of Health and Human Services, 138,000 new laboratory professionals will be needed by 2012, but fewer than 50,000 will be trained. ASCP also recently issued its 2011 Vacancy Survey of U.S. Clinical Laboratories, which found that histotechnicians (those who prepare tissue for examination in labs) are in demand with a vacancy rate of nearly 10 percent. The report notes the problem will only get worse as baby boomers retire. In the next five years, 18 percent of laboratory scientists in immunology departments, and more than 15 percent in histology and chemistry departments will retire.
Additional Survey Findings and Methodology
Additional findings of the ASCP survey, which was conducted in part to recognize National Medical Laboratory Professionals Week (April 24-30, 2011), include:
§ 74 percent of adults in the U.S. believe that at least 50 percent of doctors’ decisions are based on lab tests.
§ 84 percent recognize that lab tests are conducted by laboratory professionals.
§ 57 percent expect to get routine test results within a week or more and 41 percent expect them in a day or less.
§ 63 percent expect the results of biopsies that test for serious disease should be received within a day or less and 37 percent expect to wait a week or more.
The ASCP consumer survey was conducted March 10-13, 2011, by Opinion Research Corp., Princeton, N.J. More than 1,000 male and female adults over the age of 18 were randomly selected to participate in a telephone survey that focused on knowledge of the medical laboratory profession and lab results.
More About ASCP
Founded in 1922 in Chicago, ASCP is a professional society with more than 100,000 member pathologists, residents, laboratory professionals and students. ASCP provides excellence in education, certification and advocacy on behalf of patients, pathologists and laboratory professionals.
More information about laboratory professionals is available at www.ascp.org.
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