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OPINION

Where will you go for laboratory tests?

It is your choice to go to a good lab; no body can dictate you in this aspect even if it is your physician. The important thing is that you must go to a laboratory and imaging center where all facilities are present to perform the test and the tests are done as per standard procedure and with proper quality assurance

PROF DR MD TAHMINUR RAHMAN
Now a days diagnosis of diseases depend mostly on different laboratory and imaging tests apart from the clinical history, physical examination of the patient because of complexity of disease and its diversifying presentation. It is natural that your physician may advice you investigations depending on his/her assessment and you should select the appropriate laboratory where you will do the tests. No body can dictate you in this aspect even if it is your physician. The important thing is that you must go to a laboratory and imaging center where all facilities are present to perform the test and the tests are done as per standard procedure and with proper quality assurance.
What are the criteria of a good and standard laboratory you will look for? A good laboratory must have adequate space for patients and their attendants, must be located beside a main road with parking facilities. The reception must be well manned, computerised, must display list of tests performed with their price and delivery of reports in time. Adequate and qualified man power in all departments, adequate and latest equipment's with proper maintenance facilities, lift for going to different stairs, wheelchair for seriously ill patients, proper first aid, laboratory safety procedures including tackling of emergency and fire, prayer room, canteen, lobby, miking system or PA system for calling patients in different rooms for different tests etc.
A good laboratory must explain to the patients about the tests to be done, whether the patients has taken exact preparation for the tests, for example if a fasting blood sample is advised, the patient must fast for a minimum of 8 hours to 12 hours depending on the type of test, how much blood they are going to take, what are the side effects while drawing the blood sample and consent from the patient before taking any samples. This will ensure better satisfaction to the patient and easy collection of the samples and better reliability for the tests to be done. The lab must inform the patient about the timing of delivery of the report. For example culture and sensitivity reports take 2-3 days, so if you are informed about this it will be helpful for you to come after 2-3 days to collect the report. Also histopathology reports need a longer time for processing of the samples, staining, microscopy and reporting. So this should be explained to the patient by the lab reception.
If there is any erroneous, doubtful or contradictory results, the lab should repeat it for several times, ensure whether it has been done with quality assurance and often send it to other recognised lab for checking. If the patient notices, variable test results must bring the issue to the lab authorities, discuss it with the specialists in-charge and repeat the test with fresh sample to confirm the result.
Patient and his/her attendants’ role for giving proper sampling is also important. For example before giving any sample ensure that the test tube or container where your sample will be taken is properly labeled or marked. Ask the lab attendants or technologists to give you clean, washed test tubes or containers for giving urine/stool/sputum or other body fluids for testing. If a dirty container is supplied, reject it and ask for a new one. While giving urine for culture and sensitivity ensure that a sterilised test tube or container is supplied to the patient and then give your sample. If electrolyte test is advised don't give sample from the hand receiving intravenous infusions and look carefully whether the sample drawn is red or hemolysed. If so ask the technologists to draw fresh blood sample; other wise it will hamper the results of the electrolyte test and will give very high results which will hamper the treatment of the patient and may bring dreadful consequences even death of the patient.
Before leaving the reception counter ask the reception about the consultants in charge of the department who is going to perform the test. Also take a computerised receipt from the counter mentioning the appropriate name of the test you required, date and time of delivery and price of the test clearly mentioned in the receipt.
However the most important part is that who is going to monitor whether a lab is good or not. For this, establishment of a Central Reference Laboratory is a must and demand of time.
This will lead to early diagnosis, better treatment and unnecessary wastage of time in running after different labs for good results. This will also help in curtailing the monetary burden on the patient and his family.
The writer is a Professor and Head of Department of Pathology of Ibrahim Medical College and Chief Advisor, Pathology, NHN, Dhaka.