Blood tests at the chemist is like getting your car serviced at the lawn mower shop

Blood tests at the chemist

Chemist shops are the right place to get your medicines and receive medication advice, but they are the wrong place to get a blood test.

AMCAL chemists are offering customers pathology tests at a cost of up to $220.

Ordering a test through a pharmacy chain rather than your local GP creates risks for patients including fragmentation of care, unnecessary duplication of tests, confusion about the interpretation of the results and increased out-of-pocket costs.

It may lead to incorrect, incomplete and unnecessary tests as well as wrong conclusions and false reassurance.

A pathology test should be recommended based on a medical assessment which may include your personal medical history, symptoms and a physical examination. Pharmacists do not have the diagnostic skills required to provide this kind of care safely.

AMCAL customers will be paying out-of pocket and are not eligible for a Medicare rebate. For example, a vitamin D blood test will cost $89.50, a ‘fatigue screening’ $149.50 and a ‘general health screening’ $219.50.

Our Australian Medicare system reimburses patients for a range of pathology tests after an appropriate assessment by a doctor.

The standard packages sold by AMCAL may not include the tests that are required for your unique circumstances or health problems.

We really need better integration of health services in Australia. We need pharmacies to work together with GP teams, not introduce more commercially driven duplication and fragmentation of services.

Pharmacists add value when it comes to medication management and safety, but they are not adequately trained to give advice either before or after a blood test.

Ordering a pathology test through the chemist is like getting your car checked at the lawn mower shop. Nothing wrong with the lawn mower shop but it just isn’t the right place.

7 thoughts on “Blood tests at the chemist is like getting your car serviced at the lawn mower shop

  1. Pingback: From knitting to lawnmowers: more GPs slam Amcal pathology - EcoGreen

  2. What’s the harm being done if a test is paid for privately through the pharmacy? Worst case scenario, if the test wasn’t necessary, then that autonomous patient themselves bears the consequence of the test, keeping in mind informed consent is implied. This saves money in the Medicare budget for rebates on other tests.

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    • Dear anonymous, the question ‘what harm is being done?’ in relation to medical tests is an interesting one. This article from the BMJ quality & Safety explains some of the many causes of potential harm that may result from testing:

      “The mechanisms by which these causes lead to diagnostic error can be easily explained. When an inappropriate test is ordered, a false positive result can lead to diagnostic error. It may also lead the clinician to interpret results as actionable which, in turn, can lead to unnecessary tests, procedures or treatments which may result in patient harm. As important, when an appropriate test is not ordered, the clinician misses key information important to a correct diagnosis.

      Even when test ordering is appropriate, the misapplication of test results can result from cognitive failures by the clinician, whether from misunderstanding the clinical implications of a result, or from failing to understand the limitations of the test methodology (ie, statistical variations, performance limitations, or interfering substances). Misapplication can also occur when a patient provides erroneous or incomplete information needed to correctly interpret the result. Regardless of origin, any misapplication of results may lead to an erroneous diagnosis.

      Delays in the Total Testing Process may occur at the preanalytical, analytical or postanalytical stage, from initial ordering through the timely retrieval and application of results. Delays are problematic if a patient’s health deteriorates during the delay, or if the effectiveness of treatment is compromised.

      Finally, the result of an appropriately ordered test can be inaccurate due to analytical issues, such as an improperly calibrated instrument, or non-analytical issues, as occurs when a result is assigned to the wrong patient. Both can lead to inappropriate diagnoses.”

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    • There are a few issues:
      1. Informed consent.
      Reading the media releases and social media statements by the people behind theventure their target population is:
      a. Relatively young and healthy people who are simply curious about their health
      b. People that would not otherwise be considered for Medicare funded testing as there is no medical indication to test them.

      Informed consent should therefore be “there is no medical indication for this testing and it is purely for voyeuristic purposes and for the Chemist to make money ”

      (A great comparison is comparing a genetic study done at a place like Ancestry vs doing one at a pathology lab for a medical reason – same principles)

      Who deals with the results.
      The Pharmacy industry has on several occasions used locations such as Canada to justify these issues. A closer look would show that over there Pharmacies remain responsible for dealing with such results – even after hours.
      Not so in Australia. All abnormal results (and we can have a separate discussion on the ability of someone to interpret these issues after only a 6h course) are bounced to a GP – who may or may not have seen the patient in recent times, who has no idea about the clinical context of the results being dealt with (results should always be preceded by a proper history and examination) yet is now stuck with the Duty of Care of tracking down the patient and dealing with the results (which may or may not be clinically significant). In the meantime the Pharmacy has pocketed the cash and had moved on to the next gullible customer.
      One could even argue if Medicare should be charged at all for the role a GP plays in this – if there was no medical indication for the tests in the first place how can we let the taxpayer fund the subsequent messing around. So do the GP just cop all the expense of tracking down the patient or should we charge the patient for it? Or would the fairest option not be to simply invoice the pharmacy for the work done?

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  3. Pingback: From knitting to lawnmowers: more GPs slam Amcal pathology

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