Over-the-counter blood tests prey on patients and put extra pressure on GPs, says Dr Copperfield
Coming soon to a consulting room like yours, an interaction like this:
A woman who knows she’s anaemic because the over-the-counter diagnostic blood test kit said so, twice. Which must be the explanation for her tiredness, rather than the fact that she’s a single parent with two children, running a business under huge stress, having a couple of years ago lost her husband to a serious blood disorder, who presented, yes, with anaemia, albeit not diagnosed over the counter.
So she’s ultimately pretty happy when the lab tests I arrange come back 100% normal, though it takes a good deal of unravelling the confusion, misconceptions and anxiety her self-testing caused.
Now, that’s not exactly a double-blind randomised controlled trial. But it does reinforce my notion that the new trend for OTC blood testing might represent yet another reason why we GPs are becoming increasingly reluctant to get out of bed each morning.
As does my reading of some PR blurb I saw recently announcing the arrival of yet more DIY blood tests. Apparently, this represents the ‘democratisation’ of healthcare generally and of testing in particular. Amazing word, ‘democratisation’. Democracy is so sacred that appending it to absolutely anything renders that thing incontrovertibly good, too. Though I’m not sure that logic would hold if you democratised pilots’ licences.
Besides, the ‘blood test first’ approach completely inverts the sacred diagnostic process. There’s a reason why we do history/examination/investigation, and in that order: it’s because it’s based on science and logic, and is a sequence with decreasing diagnostic return, as anyone who has spent a day in general practice, as opposed to behind a counter, will tell you.
Call me cynical, but I’m starting to think that this all-u-can-eat self-testing might be less about empowering patients and more about preying on their neurosis and curiosity, with no thought for the consequences.
Which will be that we can look forward to many more of the consultations. But that’s fine, it’s not like we’re busy. But I do object to using the NHS to mop up the fallout for tests that are meaningless, inappropriate and I didn’t order.
That’s why I think our democratically elected Government should compel the companies making these tests to fund the initial follow up of ‘abnormal’ tests through the private sector.
Then we can really see how much they like democracy.
Dr Copperfield is a GP in Essex. Read more of his blogs here