What is the history of LMC’s patient requested Lab testing service?

Since 1985 Pathology Associates of Lexington, P.A. (P.A.L.) has sponsored a patient-requested laboratory testing service. This service was not commercially advertised but was offered as one of several public services of P.A.L.'s association with LMC. Recent commercial laboratory advertisements of patient-requested laboratory testing and of "drug-store" testing have prompted us to publicize the availability of LMC’s services as a local, physician-directed, medical laboratory alternative to out-of-state commercial laboratory services.

This service, initially planned by Drs. Shaw and Carter in 1974 and active for over 15 years, is not intended to bypass or substitute for an ongoing patient-doctor relationship with your personal physician. It is, however, offered as a ready access service and convenience to informed patients who are interested in specific aspects of their healthcare. Patients using this service should be aware of both the uses and limitations of this service; and, while we stand behind the accuracy of each test result, a single laboratory test result usually cannot be generalized to reflect a patient’s general health situation.

Do other hospital laboratories offer a similar service?

Lexington Medical Center is the first hospital in South Carolina to offer "Lab Tests On-Demand" physician directed patient requested laboratory testing and, at this time, we remain the only hospital performing this service. It is offered as a patient convenience service, one of the many patient-focused services of Lexington Medical Center.

What are the limitations of patient requested lab testing?

This service is not intended for urgent medical situations, and it is definitely not a substitute for an ongoing relationship with a personal physician. Patients choosing to use Lab Tests On-Demand must be aware that a laboratory test is only a diagnostic aid in screening for disease and monitoring the state of health or response to medical therapy. Some basic tests such as pregnancy tests are often self-explanatory. Other tests, if not carefully selected, may produce misleading information that could be unnecessarily alarming or produce a false sense of security.

Are these lab tests physician approved?

All procedures are done by fully certified Medical Laboratory personnel in the fully accredited laboratories of Lexington Medical Center under the direction of board certified physician specialists in Laboratory Medicine (Clinical Pathologists). The tests offered by Lab Tests On-Demand have been pre-approved by our Clinical Pathologists to be logical screening or monitoring tests for a person with interest in their personal health needs and health maintenance. Tests that are not on the pre-approved list may be offered by special request of the Clinical Pathologist if there is a specific and reasonable reason for the patient to have the test performed.

Why don’t you recommend shopping center/do-it-yourself lab testing services?

Our laboratory tests are done by fully certified Medical Technologists within a fully accredited, quality controlled, quality assurance system under the direction of physician specialists in Laboratory Medicine. "Do-it-yourself" lab tests or unsupervised testing services may be accurate much of the time but simply do not have our confidence as to the overall accuracy that our laboratory testing service can offer.

Why don't you offer a large, Multi-test "Executive Profile"?

There are several reasons for not offering a large "Executive" profile, most importantly because a 20+ test laboratory profile is statistically prone to produce at least one test result that is outside the "normal" range. Thus a large multi-test profile may lead to confusion and unnecessary follow-up testing rather than provide truly valuable information. All laboratory test results are most useful when knowledgeably interpreted in context with a patient's overall health situation and when focused on a specific health question.

Why don’t you offer Strep Throat screens?

For several reasons: In spite of commercial advertising claims, we’ve found through extensive on-site testing that "Strep-screens" have a significantly high false-negative rate. A positive Strep-screen result is almost always a true positive result. We do bacterial cultures on all negative Strep-screen specimens, and at least 25% of these negative screen results turn out to show positive growth for the strep throat bacteria.

Also strep screens are often requested on young children with high fever, and these children need to be directly evaluated by a physician if they are truly sick enough to warrant a screening test for strep throat.

What does my Cholesterol level mean?

Most people (and many physicians) don’t know that a cholesterol level is not stable within a person as is their height, age, weight, etc. It has been published in the medical chemistry literature (and we’ve done confirmatory tests in our laboratory) that a person does not have a single, stable cholesterol level but rather a range of cholesterol levels that can vary + 20% from the person’s average level. We’ve also determined that it takes at least four, more likely five different cholesterol determinations to establish a person’s cholesterol range. In other words, a single cholesterol level of 180 mg/dl might reflect the low, the mid or the high point of a person’s cholesterol range, and that person could have cholesterol levels ranging from 150-215 mg/dl.

You may thus note that TV commercials where someone claims a decrease of 15 points on their cholesterol level might merely be showing a normal variation of their cholesterol range rather than a true response to medication.

Why don’t you offer a legal chain-of-custody with the urine drug screens?

We simply wish to keep all of us out of court and out of the time-consuming process of legal depositions and testimony. We offer this test with a very secure patient identity system, as all of our laboratory samples have to be specifically and closely identified throughout the testing process. We’ve found that there are different personal reasons for requesting a urine drug screen. While we vouch for accuracy of results, these results are intended purely for the personal information of the person requesting the test. These results are strictly confidential and hopefully will be used constructively.

Our laboratory does do a large number of drug-abuse screens with legal chain-of-custody for law enforcement purposes, and we are very comfortable with the legal requirements stemming from these tests. When we are maintaining a legal chain-of-custody, we implement a strict security to prevent alteration of the specimen. For purposes of our patient requested testing, we caution that a diluted urine sample (too much fluid intake, coffee, etc.) can give a false-negative result.

Of what use is a Serum Iron Profile?

The most common genetic disease in Caucasian Americans involves excessive overload of body iron stores, namely Hereditary Hemochromatosis. This disorder affects roughly 1 of 200 Caucasian Americans and is often slowly progressive and fatal if untreated. Excessive body iron stores can be very toxic to vital organ systems. The treatment is, however, very inexpensive and uncomplicated, namely having pints of blood drawn with sufficient frequency to take off excess iron stores.

LMC has South Carolina’s first hospital-based Hemochromatosis Registry dedicated to the diagnosis and treatment of this disorder.

Also, iron deficiency anemia, often resulting from excessive blood loss, is probably the single most common form of anemia in adults and may reflect serious but treatable illnesses.

The serum iron profile will detect either of these conditions.

When will I get my test results?

Your results should be available the next day and will be mailed to you. (Some tests may take longer.) You will receive them in the mail provided the mailing address is current and accurate. However, if you prefer to pick the results up in person, you must present a photo ID and prearranged specific ID code before test results can be given to you. You can personally deliver a copy to your physician or we can send a copy to your physician's office if you request.

Will the lab contact me about my results?

You will be contacted by telephone only if a test result is significantly outside the normal range suggesting that immediate medical action should be taken.

What do I do if an LMC lab technologist contacts me with a test result that is outside the normal reference range?

A test result that is outside the normal range may indicate a need for follow-up discussion with your physician to determine if there are potentially significant health concerns. Patients with abnormal test results may not be aware of feeling unwell. In the event you are contacted, you may be advised to seek immediate medical attention. For this reason, it is important for you to provide an accurate and current phone number during registration. LMC’s community medical centers (CMCs) are readily available for patient consultation.

Should I tell my personal doctor about my test results?

Yes. A physician uses laboratory test results in addition to other factors to diagnose and treat diseases. If you list a personal physician, and if you request that we do so, we will send the test results to your doctor for you.

Can I take a copy of the lab results to my doctor?

Yes. Your lab report is completely official, is recorded in LMC's lab computer files, and will include all the standard data that doctors typically expect to see with your lab result information. We will send a copy of your results, if you wish, to your physician if his/her name is supplied when your sample is obtained.

What if I don't have a personal doctor?

We recommend you visit Lexington Medical Center's website at www.lexmed.com which provides a comprehensive list of physicians in the LMC network. You may also call LMC's Physician Referral Line at 803-791-2271, and a representative will refer you to an LMC-affiliated physician or send you a Physician's Referral Guide. You may also wish to visit one of Lexington Medical Center's six Community Medical Centers located throughout Lexington County.

Does my insurance cover patient requested testing?

No. These tests would not generally be covered by insurance, or Medicare or Medicaid.

What payment methods are accepted?

We accept cash, money orders, and personal checks imprinted with your name. We also accept Visa and Master Card.

Can I be billed for these tests?

No. Billing for services adds considerably to the cost of testing. This limited test menu is offered at a significantly discounted rate because we avoid the cost of billing. Therefore we expect you to pay for your tests in full at the time your test sample is obtained.

Why do you need my personal information?

We need to know your name, mailing address and phone number in order to send results to you and contact you immediately if results indicate that immediate medical action may be necessary. We also need to know other pertinent information such as gender and age as some lab tests have normal ranges that differ based on these factors.

As for issues of privacy, at the laboratories of Lexington Medical Center, we understand that tests related to your health status are very private and confidential. We comply with all regulations related to privacy, and all medical information is treated confidentially. We want you to feel comfortable using our services, and we take this responsibility seriously. Your test results are for you to share with your physician and are not given to anyone else.

What additional tests will be offered in the future?

Yes. LMC's Lab Tests On-Demand is the first program of its kind in South Carolina. As experience and public acceptance grows, new tests will be added to the menu as interest and demand require. We welcome your comments and suggestions.

Is there a minimum age requirement to participate in this program?

Yes - as a general rule, a person must be at least 18 years of age to request testing without being accompanied by a parent or guardian.