OT: Surgery Blood Tests??

[Cursitor Doom]

Hi all,

As we know, our first port of call whenever we have any health issues that require resolution, before we visit our GPs, is to ask for help on uk.d-i-y.

The surgery I'm registered with lets me see *any* of their GPs. I've not been assigned to any one particular doctor. If I want to see any particular doctor, on the other hand, I can, but that will usually involve a longer wait than if I'm prepared to see just anyone that's available.

I normally just take anyone that's available for the sake of a short wait, but a pattern I've noticed over the last 5 years is that although I've seen *all* the GPs at this practice, there is only *one* in particular that has this habit of *always* taking a blood sample from me in person every time I see him. All the other doctors, without exception, if I require a blood test, will issue me with the relevant forms and I have to make a separate appointment with the area blood clinic to have the sample taken at some later date.

Anyone guess what's going on here? Was this doctor a vampire bat in a previous life? Or is he trying to clone a copy of me? Or does he suspect I'm an alcoholic/drug addict? (I'm not and have given him no reason to suspect so - I don't even smell of cigarette smoke since I don't indulge). I know this is a difficult question, but if anyone has any hunches as to what's going on, I'd be grateful to hear them.

-Puzzled, Leeds.

[charles]

perhaps he's keener than the others that you don't suddenly drop dead.

[Chris Hogg]

Maybe it's part of a national survey or whatever of the nation's health, every surgery/practice having to supply blood test results from a cross section of the patients they see, and that particular doc drew the short straw when they were deciding which doc in the practice should test all the patients he/she sees.

[Nightjar]

It suggests to me that this doctor is the only trained phlebotomist in the practice. It is probably cheaper for the practice to take their own samples and submit them for analysis than having the clinic do both.

Blood tests tell a lot about our health, so I am not surprised that a particular doctor favours taking as many as possible. If, like mine, your surgery allows you online access to your records, you can see just what tests were done on the blood and the results, compared to the normal ranges. Last month I had four samples taken that, between them, gave 10 sets of results. All were within limits, except for slightly low potassium level, which could indicate that my dose of diuretic is too high. A re-test a couple of weeks later showed it was back within normal limits.

This site explains all the tests that can be done and why:

[Mr Pounder Esquire]

Quite possibly he is the only one who has a qualification in Phlebotomy.

[Andrew]

What qualifications ?. Most bleeders do not have any background in medicine, nursing or science.

[alan_m]

As GPs don't normally take blood sample perhaps this doctor is more experienced in the procedure whereas the others doctors are not and prefer to have others do it.

I have to have give a blood sample twice a year and have noticed that more experienced NHS staff seem to be able to get the sample easily and quickly while those with less experience can make a complete b****** of it. The last time I gave a sample at the local hospital I noted that one nurse was dealing with 3 patients for every one that the other nurses were seeing.

[Mr Pounder Esquire]

HTH

[polygonum]

That site also uses the preferred term "Reference range" rather than "normal range".

"Reference Ranges & What They Mean Test results are usually interpreted based on their relation to a reference range. This article will help to explain what a reference range is, what it isn't, and why test results and references ranges should not be interpreted in isolation."

[polygonum]

Assuming England (I don't know about the other constituent countries of the UK), GP surgeries had for years been paid to perform phlebotomy but ma had done absolutely none. My former practice was one such. When this was pointed out as being a potential breach of their contract, many surgeries introduced, re-introduced, or enhanced their phlebotomy offering.

I still always chose to go to the hospital phlebotomy unit because they opened at 08:00 rather than 09:30 or later and could get blood in a minute or two.

[James Wilkinson]

Since every nurse does, I would think GPs most definitely do. They just like to delegate such menial tasks.

[Tim+]

More likely he can claim a fee if he does a blood test. Sadly a *lot* of what GPs do on a routine basis is influenced by remuneration.

Tim

[NY]

I need to have a blood test taken every year and the nurses usually have great difficulty finding a vein. I'm not sure whether my veins are deep below the skin or narrow so blood doesn't flow very freely. They often have to search for a while, trying various sites until they choose the bets of a bad job. Only once has a nurse put the needle in and found that the blood won't flow into the sample tube, and had to try again with a needle in the other arm. The insertion of the needle is never painful and I'm not squeamish. so I can see the funny side of the difficulties I cause the nurses.

I've only experienced real incompetence and that was back in the days when I used to give blood. The nurses who normally inserted the needle did a perfectly good, professional job. One time it was an elderly doctor who looked like Rosa Klebb who put the needle in - and she made a real hash of it. That *was* painful. Her hands were shaking and she kept stabbing the needle in. Eventually a nurse said "shall I have a try" and I'll never forget the look of gratitude from Rosa :-) I had a nasty bruise from where Rosa had kept trying to insert the needle into the vein, and the nurse who finished the job (competently) sighed but was very loyal to her colleague even though I reckon I know what she was thinking.

[Roger Hayter]

Combination of a career-long habit and a desire to save his patients time and trouble?

[Roger Hayter]

I don't know what happens nowadays but in previous generations doctors needed a qualification in phlebotomy about as much as they need a qualification in wiping their own bottom. It is normally something self-taught after a brief acquaintance with the kit supplied, and no doctor fails to learn it at a very early stage in their training.

[Roger Hayter]

Most won't pay for them now as they are regarded as cosmetic.

[pamela]

The practice can charge the local clinical commissioning group for those minor procedures.

[NY]

In previous GP surgeries that I've used, GPs have usually tended to take blood samples themselves. The one I'm with now never does that: they always refer me to the nurses in the same practice, which means making a return visit in a few days' time when they can fit me in. I wonder if there has been a change in policy, which means that GPs aren't expected to be trained to take blood, or whether they regard it as beneath their skills to "merely" take blood.

Likewise for injections such as flu jabs - always a nurse at a later appointment, never the GP during the original consultation.

[pamela]

I think a GP who takes the blood sample during a consultation is just being helpful and saving a return visit.

Mine does that and he has also given me a flu jab during a consultation for something else. Suits me fine.

[alan_m]

It may depend on the size of the GP practice. Mine has around 8 doctors and 3/4 full time nurses. Flu jabs are always performed by the nurses and in recent years, phone up for a Saturday appointment and walk out a few minutes after turning up. If actually seeing a doctor at the time of the jabs it's a quick note on the computerised records a short wait on a first come first served basis at the nurses room.