Herald Hysteria

Well the Saturday Herald is splattered with so many hysterical articles about the evils of Labtests that it almost seems they have been bought out by DML. The articles range from the idiotic to the actually concerning (if true). There is the sad tale of the GP who wants to leave Auckland because Labtests is so terrible. To my shame, I confess that I laughed out loud when I read this completely over-the-top response to the situation. Apparently his main complaints are that his patients have to travel for their tests (but his practice nurse could take the blood, if he felt that strongly about it) and he can’t directly compare results because labtests results have different ranges or units.

Another article contain a litany of GP complaints, some of which are valid. However, there is every indication that these are complaints stored up from the initial change-over. Labtests took over from DML in my area last week and no one in my group practice has experienced problems so far (barring the odd spurious result). One of our specialists was blaming Labtests for a blood test that had been delayed for two weeks, until I pointed out that DML was responsible for the test, not Labtests as Labtests had only started the previous week. It appears to me that Labtests has corrected its biggest problems already. Most of the doctor’s recent complaints are merely annoyances, rather than critical errors.

Ron Paterson has his say about Labtests, based on the 13 complaints he has received so far (apparently he considers 13 complaints to be coming in “thick and fast”).

““The information I have received indicates there may be a risk to public safety given the broad concerns that have been raised.””

This is a strong statement considering he has not investigated any of the complaints, he does not know if any corrective measures have been put in place and there have been no cases of patients being harmed. The two most serious complaints – delay in home blood testing and results faxed to the wrong place, I have experienced with DML (the “perfect” provider). DML continued to send me an INR belonging to a patient I had seen briefly two years ago, in another practice, despite four phone calls to the lab to try and correct the error. These faxes have only stopped because of the switch to Labtests!

One article quotes some of the complaints received by HDC. These are predominantly about delays in blood tests (fixed), delays in receiving urgent results (fixed) and the technical skills of the phlebotomists (merely a matter of experience). Note that doctors have not been rung or faxed mostly because Labtests has not had all the GP’s details. This problem would not have occurred if DML had allowed Labtests access to their GP database and allowed them to use the same GP codes. DML’s response:

“DML’s director of clinical services, Dr Paul Ockelford, says Labtests asked for DML’s database of doctor codes. DML refused, because it was intellectual property it owned and there were confidentiality issues.

““They wanted all this information handed to them on a plate. It includes urgent numbers given to us on the basis we would only contact doctors if we had to, using cellphones out of hours. They wanted a free look at that on the basis they hadn’t done their homework.””

Codswallop. DML were just playing dog in the manger, as usual. This was not intellectual property, it was information given by GPs on the understanding that it would improve their access to lab results. There is no value in this information, except as an adjunct to a good lab service. DML could not sell this information to anyone else (with the possible exception of Labtests themselves) nor could they make money from it – it was therefore NOT intellectual property.  Confidentiality issues are a complete chimera. The prime reason they withheld it was to make Labtests look bad. As far as I am concerned this gives them the moral stature of pond scum.

John Roughan has an interesting take on the whole affair, which he portrays as a squabble between doctors and the “bean counters” and tips the doctors to win, as usual. He predicts that the doctors will eventually win concessions from Labtests that will lead to most of the savings from this exercise being whittled away. I suspect he is likely to be correct. Removing the gold-plated service run by DML has produced a large number of disgruntled doctors prepared to exaggerate the short-coming of the new service in order to force the “bean-counters” to admit the error of their ways. It is possible that millions of dollars in potential savings will be lost simply to have dozens of near-empty waiting rooms, so patients will not have to wait and doctors can declare victory. As Roughan points out, short waits are not a situation that extends to doctor’s waiting rooms, so there is a great deal of irony in this.

Considering the logistics of an operation of this size, coupled with the total lack of co-operation from the incumbent laboratory, DML, I think that things have actually gone remarkably well. By this time next year, there will no longer be an issue in the  minds of most doctors. Some of my colleagues, of course, will simply never be happy with the new lab, but will gradually be consigned to the same place as the “in my day” reminiscers. Hopefully, there will still be some savings left when doctors have stopped picking holes and settled down. Otherwise this whole affair will have been rather pointless.

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