Extending or ignoring reference ranges is part of GP culture

Salisbury admirably confesses to filing laboratory results just out of normal range as satisfactory.1 This is an established culture. Of course, our self-generated reference ranges are quite arbitrary and likely vary a bit. Extending reference ranges or ignoring indices that traditionally mean little, like the mean corpuscular haemoglobin concentration, are two of the many little techniques that make up GP work. But explaining why you ignored a red result to an anxious, motivated patient can be disproportionately stressful. If such a patient makes a complaint, the stress can escalate. And small numbers of such cases can be another nail in the coffin of a GP’s motivation.The flip side of this is that the patients challenging the ignoring of such results might be revealing an inappropriate culture. Why do laboratories still report indices that almost all GPs ignore? And if you think this to its conclusion, then an abnormal result might…
Read Original Article: Extending or ignoring reference ranges is part of GP culture »