Why should I pay for tests. : Dr promised to test... - Thyroid UK

Thyroid UK
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Why should I pay for tests.

lexilou
lexilou

Dr promised to test t3 as said I may have a conversion problem, went for test yesterday asked nurse what was being tested, tsh and t4. I'm fuming wouldn't have bothered going if I had known.

Why won't drs do this test, I'm now gonna have to get this done privately and if It comes back I have a conversion problem I should be able to send him the bill.

Sorry for the rant but I'm so ill and about to loose my job and you just have to look at me to see how ill I am and he does nothing.

15 Replies
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Hi lexilu - even when my gp explicitly requests T3 it is ignored by the lab. They will only test if they feel it is necessary.Its outrageous that qualified doctors' requests are ignored in this way :/

lexilou
lexilou in reply to jezebel69

Hi jezebel,

My Dr said they don't usually test it if your TSH is in range, the thing is they definitely wont test it if he doesn't request it.

Hidden
Hidden

Even my consultants t3 request has been over ruled by the labs! We have gound if the doc writes Graves Disease on the request form it gets done.

helvella
helvellaAdministrator

What always gets me about this (on top of all the other issues) is that the lab doesn't report back to the person requesting the test why it was not done. So doctors might keep asking and never know what they need to do.

In my book, there should be an explicit duty on anyone doing a medical test to report back to the person who requested it. Absolute. With no wriggle room. Failure to report back should be a serious issue.

With that in place, it is possible that the doctors will understand better what they need to say, how they can justify requests, etc.

Rod

Kathy21
Kathy21 in reply to helvella

At the end of the day it seems our medication is determined by a lab technition and not by a doctor.

HarryE
HarryE in reply to helvella

I work in a lab, and this is exactly what we do. Every sample gets a report issued to the requesting doctor, even if that report says why a test is inappropriate or not allowed due to funding. If there is any doubt, I ring the doctor and ask.

helvella
helvellaAdministrator in reply to HarryE

Glad to hear that. Nothing else is acceptable.

I have certainly watched a GP who looked entirely confused as to why, for the third or fourth time, a test that was requested (fT4 and fT3, I think), had not been done and nothing on the records. (Our results are entered by the lab and the GP can see them in screen.)

HarryE
HarryE in reply to helvella

We do very different testing to thyroid, but it should happen everywhere in my opinion.

It would have been a good idea to ask the nurse to check with the doctor as you had been told it would be done. Possibly there was an admin mix up.

If your doctor does request an fT3 and the lab does not do it bear in mind that GPs are incredibly busy and won't have time to chase it up. (Some GPs know it will be turned down and so are happy to put it on the form to get rid of you). It's up to you to contact the hospital (or lab) and make a complaint, initially a polite one via the PALS service but if that doesn't bring success then a firmer and more formal complaint. If you can't be bothered to make a formal complaint then you only have yourself to blame. OK, I know I'm being harsh, but how else are we going to make progress? When a lab assistant overrides a qualified doctor the tail is wagging the dog. If we all make formal complaints they will get fed up and change their ways. These people seek out the path of least resistance, using so called 'guidelines' as excuses.

I complained and gave a reasoned argument why I needed fT3 and they did it. It failed another time when the hospital changed labs so I complained again, it has been sorted. The new lab requires a particular form of words on the form, the NHS is too meek to tell the lab to just do it.

sip1
sip1 in reply to jimh111

I think the problem here, is that most of us don't have the energy to chase after these things. It personally takes all I have just to go and see the doctor - I suffer with anxiety at the best of times. For me, I'd rather just pay and get the tests done myself. I know this isn't ideal, and the doctors SHOULD do them, but it does sometimes feel like too much effort and I simply don't have it in me.

helvella
helvellaAdministrator in reply to sip1

I did exactly that. PALS eventually provided contact between me and head of lab. He then authorised fT4 & fT3 tests - and they were done.

From jimh111 that was good because it raised the issue, etc. From sip1's point of view that was too much to manage.

Overall I feel that while the testing was achieved, it was ridiculous and I doubt it has helped anyone else, at all. Sadly. But it still needs to be done.

Rod

I've had T3 tested t the GP surgery. Firstly it was on the screen as being requested and GP aware of it, then the nurse requested it. Basically T3 is lowered down the screen under f for free T3, whereas thyroid blood test is just TSH and T4. Even so, with both ticked on the screen, there are no guarantees, because it's wrapped up in the whole culture of not testing for it, not prescribing it, and pharmacy not routinely stocking it...

On this occasion it wasn't done. So I made another appointment. I told them what happened. A day later I went back, to see if it was being done. The receptionist said it won't be ready yet. So I had to explain wasn't done properly, and I'm aiming to grab them before my sample is discarded, because if that's the case, they can still re do it.

I got assurances that they'd chase it. I wasn't filled with much hope. But between the GP, nurse and receptionist, they spent all day on the phone, to make sure it's done!

They didn't forget after that! Plus I really thanked the staff for their trouble.

It proves it can be done. I can't imagine every surgery would go through all that trouble. But it meant that they know me. Plus the time after the nurse agreed jokingly that I need that T3 tested after what happened last time. I think At the lab they made some sort of special record to do it.

I'm another one who has complained to the lab and now gets TSH, FT4 AND FT3 done each time. I explained in great detail where my tests were sitting and why an FT3 result was required, and the effect on me if it was not provided and got a two line e mail back within 24 hours basically conceding and saying they would do them in future. That's enabled me to prove to the GP that I am not hyper and stop him reducing my meds.

If you don't do that, they only do TSH, unless that is out of range, in which case they will do FT4.

FT3 they don't do, even at endo's request for my friend with Graves.

They have other rules too, like only testing ferritin once every three months and vitamin D annually.

It's ludicrous and clearly designed to save money at the patients' expense.

It is ridiculous to split GP, Consultant and Labs costings as all three parts are need to make a correct diagnosis. They all seem to be trying to protect their own budgets while the poor patient suffers. Am beginning to wonder why they are paid out of the taxpayers money when they are not really treating at all. Janet.

That's exactly what happens jbee! Individual budgets and no joined up thinking!

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