Ronald B. Keys, JD, PhD
Free Initial Consultation Call: (954) 448-1515 E-mail: email@rkeysphd.com |
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Free Initial Consultation - Call Now (954) 448-1515 QUESTIONS AND ANSWERS ABOUT LAB WORK by Ronald B. Keys, JD, PhD Online Consulting PhD Co-Director of the American Aging Association PACE Certified, 1996, 1997 by the American Society For Clinical Laboratory Science Former, NY City and Florida Metropolitian Radio Talk Show Doctor, 50,000 Watts WEVD, 1050 AM on Cutting Edge Changes in Clinical Medicine Q: Why do I need laboratory studies? A: Any health care provider has to be competent. The exercise of sound clinical judgement by a health care provider should be based upon not only his/her experience and other clinical skills but the physical characteristics of the patient. The physical characteristics of the patient are based upon a physical examination if the provider is a physician and the results of appropriate laboratory studies. Most of the time, clinical intuition is not enough. Laboratory work gives the provider a number which is either above, below or within a given reference range on a particular item. This value may be marginal or critical (important) in nature, depending upon the variance from the reference range, the validity, reliability, descriptive nature and extent of the reference range, patient history and the presentation of symptoms. Patterns of laboratory values are sought, using PATTERN RECOGNITION ANALYSIS to understand what is happening to you. See: Lundberg, GD. Critical (Panic) Value Notifications: An Established Laboratory Practice Policy (Parameter). JAMA 1990;263:709, Catrou, PG. Editorial: How Critical Are Critical Values? AM J CLIN PATHOL 1997(Sept):108:245-246, Emancipator, K. Critical Values: ASCP Practice Parameter. AM J CLIN PATHOL 1997(Sept);108:247-253. Novis DA, Detecting and preventing the occurrence of errors in the practices of laboratory medicine and anatomic pathology: 15 years' experience with the College of American Pathologists' Q-PROBES and Q-TRACKS programs. Clin Lab Med. 2004 Dec;24(4):965-78. Q. Will my doctor know what to do with the laboratory results? A. Sometimes yes, sometimes no. And oftentimes, not, depending upon the provider?s familiarity with the particular tests. There is substantial agreement among practicing physicians, particularly those in primary care, that advice on the selection and interpretation of laboratory tests is a frequent and unmet need....The size of the clinical laboratory test menu has increased substantially with more questions from physicians (See Kirby, JE, Laposata, M. The Nature and Extent of Training Activities in Clinical Pathology Required For Effective Consultation on Laboratory Test Selection And interpretation. ARCH PATHOL LAB MED 1997;121:1163-1167). This problem is even more serious in orthomolecular and functional medicine with new and advanced clinical chemistries and their interpretation which are largely unknown by mainstream physicians. (e.g. Abrams, MB et al. Early Detection And Monitoring Of Cancer with the Anit-Malignin Antibody Test. CANCER DETECTION AND PREVENTION 1994;18(1):65-78, Lord, RS, Bralley, JA. Organics In Urine: Assessment Of GutDysbiosis, Nutrient Deficiencies And Toxemia. 1997(June):NUTR PERSP, 1997(June);1-5, O?Leary, JJ et al. Origins Of The Polymerase Chain Reaction In Pathology. J CLIN PATHOL 1997(Sept);50:805-810. Novis DA, Detecting and preventing the occurrence of errors in the practices of laboratory medicine and anatomic pathology: 15 years' experience with the College of American Pathologists' Q-PROBES and Q-TRACKS programs. Clin Lab Med. 2004 Dec;24(4):965-78. The reality is that the sheer pace of new developing biochemistries in clinical medicine and lack of time to keep up with the developing literature and required training for new testing is leaving many physicians standing in a cloud of dust. Q. How important are laboratory tests? Do I really need to do this? A. People are treated, not laboratory reports. Neverthless, sound clinical thinking oftentimes should be based upon baseline studies to guide your clinical course as a patient. Clinical decision making should not be based upon hunches orguesswork. Laboratory studies may tell us what is a proper clinical direction or whether a given clinical course is a proper one for your case or not and what type of support you require during your treatment. See: Laposata, M. What Many Of Us Are Doing Or Should Be Doing In Clinical Pathology: A List Of The Activities Of The Pathologist in the Clinical Laboratory. AM J CLIN PATHOL 1996;106:571-573, Nutting, PA et al. Problems in Laboratory Testing In Primary Care. JAMA 1996;275:636-639. Novis DA, Detecting and preventing the occurrence of errors in the practices of laboratory medicine and anatomic pathology: 15 years' experience with the College of American Pathologists' Q-PROBES and Q-TRACKS programs. Clin Lab Med. 2004 Dec;24(4):965-78. Free Initial Consultation - Call Now (954) 448-1515 RONALD B. KEYS, JD, PhD CLINICAL & OPERATIONS DIRECTOR Ronald B. Keys, JD, PhD 2402 N. 28th Avenue Hollywood, Florida, 33020-1814 USA 954-448-1515 primary email: email@rkeysphd.com secondary email: rkeysphd@brainlink.com secondary email: rkeysphd@yahoo.com by pre-arrangements for voice/text chat: Mostly, Dr. Keys works as a Consulting PhD Doctor, usually from a distance, with and through a proper local anchor physician to order blood work. Advanced treatment protocols may develop from the advanced blood chemistries he requests. If you have no local doctor, Dr. Keys finds one through an affiliate physician network. His work is global, oftetimes involving patients from other countries as well as all over the continental USA. There are many tests and treatments to help people; Oftentimes, anchor physicians are not familiar or comfortable with them. Dr. Keys teaches and helps to direct individual patients AND their physicians with laboratory-work for these treatment options. This is measured work and clinical biochemistry. Opinion evidence standards are not employed here since this is a measured and laboratory-based or empirical study of the patient. Numbers are sought from the results of these tests that, usually, "...jump up and grab you..." that dictate what is needed and how much. Patient-advocacy is frequently involved to get advanced and necessary clinical biochemistries ordered and to help interpret them in filed reports..Chat room capabilities in voice or text, besides email, may be employed. This may include conference calls online. In a perfect world, if your physician knew everything, people like Dr. Keys would not exist. Physicians themselves are caught frequently in the traps of their own standards of care that may be very limited in many cases. Methods used by Dr. Keys are rational, scientific and disciplined. Designed by Fencl Web Design.Com DISCLAIMER: Ronald B. Keys, JD, PhD is not a physican. He acts here, when hired, only as a consulting PhD doctor. Any information offered on this site is intended for prevention and education. It is the responsibility of your anchor doctor or chosen physician to diagnose and treat diseases through their medical licenses. By using this web site you agree that you will seek professional medical advice from your doctor before using any of the information presented on this web site. All tests are ordered through your physician, only, and not Dr. Keys. Most jurisdictions require that an attending physician is required by law to take patient and family history, conduct a physical examination of the patient and to order tests appropriate and necessary. As an online consultant, he cannot do these things required together, as a whole, as a practice of medicine. Any emergencies should only be handled in a hospital emergency room or by your physician. |