I just started reading this thread and I have numerous misgivings about
this situation - both from a personal, pain-patient perspective and from a professional point-of-view.
One glaring, obvious red flag for this company from a professional point of view is that this laboratory does not seem to be an accredited lab recognized by the credentialing agencies that all clinical labs must have in order to be licensed to test patient blood / urine samples.
All labs in the US that are allowed to accept insurance and governmental reimbursement (like medicare . medicaid) for sevices must be CLIA '88 certified and undergo rigorous biennial inspections (at the least). All clinical labs that we are most familiar with have met this standard. Independent labs like the one mentioned in this thread - which may operate from direct billing (non-third party payers)may not meet these standards and most likely will not have any independent evaluations / inspections which ensure accurate testing with reliable methodology by following a rigid quality assurance program. I also have great unease in that the sample report seems not to meet required specifications that an accredited lab it required to incorporate into its reporting system. For example, the units of measurement for the individual analytes are not reported along with the interpretation (the "negative" is not a result but rather an interpretation) and methodology information is not provided - which alert
s the ordering physician to limitations of how the information is to be applied to the individual patient - as well as other glaring unprofessional aspects to this report (no proof of license; no director name, no contact information, etc).
As a patient, I would insist on having proof that this lab meets federal government standards for credentialing (which all labs which test patient specimens must do) and if the clinic cannot provide this information then I would refuse to submit a specimen. By law you have the right to view a copy of any clinical lab's certification - it must be provided on demand. And if no certification is available your doctor may be violating several laws - especially if he is demanding payment from you or your insurance companies. At the minimum I would request your insurance company to investigate the lab to ensure that they are accredited by a CLIA 88 recognized agency. If not, this will nip this outrageous invasion of patient privacy, as well as morally repugnant activity, in the place it will hurt them the most: their bank account. Because an insurance company can legally refuse to pay a lab which is not certified; and so can you if you were mislead in any way.
All in all this whole set-up seems very fishy to me. From the way the specimens are collected to the way the report is generated. Definitely not within the normal range of normal clinical laboratory testing - and probably not even within a forensic point of view (which is even more heavily weighted towards chain-of-evidence integrity). This is a very scary situation and as a clinical laboratory professional, I think that this laboratory may not meet the standards of testing that each of us deserves.
I know that this really doesn't help most of you in a situation like that describe above when it is forced on you - I know that the doctor can threaten you with "if you refuse to take the test then I will not write your 'script
" and I understand the helplessness that this situation engenders. But I just wanted to offer the above opinion to help you realize that testing blood and urine is much, much, MUCH more compllcated than peeing into a cup and waiting for a machine to spit out a number. Based on what I sensed from this thread and the linked website, I would suspect each and every number that is being generated by this drug testing lab and highly question the accuracy and relevance of the numbers they are reporting.
I say shame on any doctor who takes this route!
(oh - I also wanted to add for the poster who was surprised that many of us use methadone for pain control that Methadone use in the US is not limited to heroin addicts - it is recognized and accepted by most health care professionals familiar with pain management that methadone is a very effective pain medication for certain people in certain circumstances. It is one of the more highly prescribed pain management narcotics. Used under close physician supervision and within the parameters prescribed it can be a safe, effective and affordable medication for pain patients).
Post Edited (Disce Pati) : 8/7/2008 10:00:42 PM (GMT-6)