OK, firing off seven lab tests to test for the same thing is *not* a
good thing. What about ordering an ESR (or PV) every day, and a CRP
every hour while someone's in the ICU?  And what's the diff b/w CRP
and hs-CRP?

BTW, when someone's having an attack of PNH, would their RPI be much
greater then 2, since PNH causes massive hemolysis?

Thanks!!!!

Much as we hate to lose good MT's to med school, what John said is very
true. My sister-in-law was a med tech in Chemistry and then in
Microbiology for quite awhile. She went back to school in her 40's after
a divorce and became a PA (physician's assistant). She was miles ahead
of everyone in her class as far as the lab went and she ended up
teaching micro at the PA school for awhile until her hours were
increased on her job. The other family practice docs where she works
always defer to her on basic microbiology questions.  Another friend of
hers was a med tech and went onto dental school.  Same thing - the lab
experience put him way ahead of his classmates.

Another good friend was a med tech in Hematology/Blood
Bank/Chemistry/Urinalysis (i.e. general lab) for many years and was
admitted to med school at the ripe old age of 37. He's been an ER doc
since he graduated in 1986 and is in his 60's now. The lab experience
for his line of work put him ahead of most ER docs we run into.

One of our techs went on and is in Podiatry school now - same story.

Do not discount the laboratory as far as laying an excellent foundation
for medical/dental/other medical professional school. It gives you good
experience and decent income to be able to pursue med school down the
road.

As far as unnecessary testing....with online ordering (as opposed to
paper ordering - most hospitals are going to the former) many tests
cannot be ordered too many times per day anymore. Insurance
companies/Medicare/Medicaid will NOT reimburse a hospital for duplicate
testing so the system just won't let you order them. That being said,
there are ways around a lot of things - docs ranting and raving being
one of them. This does NOT go over well with the lab (we are sharper
than most docs think) and docs that chew out the lab and otherwise rant
at us get "labelled" and their reputations are spread far and wide. In
some hospitals these types of orders are reviewed by the clinical
pathologists first, especially if the test is an expensive send-out with
no clinical reason for ordering it other than ego. The clinical
pathologist is the ultimate boss of any laboratory and what they say
goes. I remember when I first started out there was one resident who
used to routinely order EVERY chemistry test on our requisition. This
required LOTS of blood in the 1970's and I remember drawing these poor
patients with a 50 cc syringe. This does NOT happen anymore. The DRG
(diagnostic related group - all Medicare patients are assigned to one
based on their diagnosis) oversight is too stringent. Hospitals get paid
a flat fee for the DRG the patient is assigned to by coders (based on
their medical records, certain in-house events, etc.). If they code
wrong and the patient is in longer than the DRG will pay for, the
hospitals eat the overage. The docs are under pressure to discharge
patients because of this and they DON'T use up DRG money on too much
unnecessary testing if they can help it. The hospitals monitor which
docs order too much.....

Judy Dilworth, M.T. (ASCP)
Microbiology