The Thing About Hurdles

I used to love track and field as a youth. I loved to watch and I loved to participate. I loved the challenge of hurdles and long distance runs best.

I never could say what happened. All I know is the person next to me slipped, falling against me, causing me in mid leap to hit the hurdle right across the knees.

It wasn’t my first bad fall and it wouldn’t be the last. It was, however, the last time I ran hurdles. Although, now that I think about it… I’ve been dealing with hurdles of one kind or another all my life. So, maybe it’s not so much that we have hurdles we have to deal with, but rather how they come at us?

Fast forward to this point in my life… I often read that in order to be engaged, patients need to have more knowledge. I’m a patient and I’m telling you lack of knowledge may not be the greatest obstacle to engagement: It’s the constant barrage of hurdles.

In my quest for knowledge, I read a study in the American Journal of Managed Care (April 19, 2017) which found that 98% of patients want to receive their results online. Can’t say I’m surprised. Top reasons why: it saves time and we get more complete information. This is what I’ve been talking about for some time now!

Many patients do not mind receiving abnormal test results. While healthcare professionals continue to be concerned that without the face-to-face interaction and personal encouragement of such a visit (to receive lab results), patients are more likely to fail to plan their next treatment steps, it is clear patients want the information in their own hands. It’s called empowerment.

Which brings us to today’s particular hurdle: Extra charges for lab test results.

I received an invoice in the mail this week for a test that is no longer covered by OHIP. It’s for AST, a “relatively non-specific marker of liver disease and therefore has limited utility in the community setting”. So, maybe there’s good reason to exclude it unless the requesting physician is a hepatologist (as indicated on the invoice)?

I just want to know how else am I going to know that my liver function is still okay considering the nasty drugs I have to take for my RA? That piece of information was not included on the invoice.

So, in addition to this valid concern, this is the first I’ve heard of it and, according to the invoice, the decision was made in 2013, although it didn’t come into effect until April 2017.

I want to know where have I been for the last 4 years when I’m sure patients were being told about these changes?

I have a standing order from October 2016 and there was no mention of this change (and charge) from the physician nor from the lab that handled my requisition.

I’m one of those people who read everything, and I do mean everything, when I’m in a waiting room. Again, nothing in any of the physicians’ waiting rooms nor in the lab where I had my lab work done for the last 4 years.

Disappointed. Annoyed. Not surprised.

Some days it doesn’t matter how hard you try to keep yourself informed, educated, and knowledgeable, you still get stuck with a nasty surprise. It’s not that I don’t like a challenge, and I’m in this for the long haul (guess I still like that long-distance race). It’s just some of these hurdles seem so unnecessary. So easily avoided.

You want the best for patients? Don’t worry about abnormal test results. I have a support network for that. Don’t worry about unclear test results. I have google for that. Changes to what is covered and what is not? Now that I could have used a heads-up on.

Oh. That’s right… Guess someone did tell me… when I got the bill.


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