Blood work BEFORE the check-up

I'm T2, with good control. With my six-month check-up looming, I called to schedule my bloodwork for the week prior to the appointment. The receptionist told me that the practice no longer schedules such tests in advance, rather the doctor will order any tests after the appointment.

To me, this seems dumb. If there are any changes in my cholesterol or A1C, wouldn't it be better for doctor & I to know at the time of my check-up?Thoughts?

That sounds like a weird plan. If the doctor didn't want to know ahead of time, I would. What are you going to talk about? The weather?

Does the practice have a PA, or a NP? I would call and talk to them rather than the receptionist and get them to order the usual tests so your doc has them to review with you.
If they are not willing to do that then it is time to find a new practice and a new doc.

That is what my endo was doing until I changed to an outside lab due to accuracy. Now I have them done 2 weeks prior so I can discuss it with him. It is kind of a pain vs having it done at their office but I don't see any point going unless you know what is going on with your blood work, unless there is some special issue to discuss.

If you think about yourself as being a medical care consumer and you want to get the most for your healthcare dollar. If you only see the endo twice a year at the very least you would want to have current numbers to discuss. I would call again and tell them what you want, not ask them.

I suspect that this is about money. You show up, they do test and then call you back if need be. Now the Doc has been paid twice when one visit could have taken care of it.

Maybe I'm jaded but sometime I think a doctors policy might have as much to do about money for the practice than for your convenience. If one holds all the cards one does play them to his or her favor.

I agree Gary. I've also had doctors who after they talk to you during the appointment decide to add to the "usual" labs based on the time of the year, your age (i.e., colonoscopy), the last time he or she ran that particular test, etc. Mom adds whether or not the wife's birthday or anniversary is coming up or a bill is due, but I'm not quite that cynical. :-)

Thanks all. I will push again to get the lab work done in advance of my check-up.
BTW, I don't see an endo, but rather an internal medicine PCP for everything. I like her, I like her practice. Just when I thought I understood how things worked with the practice, they throw me this curve ball.

I wonder where all of you live who get pre-visit tests. I live in NC, have lived in VA and near DC for the past many, many years and I have never had an endo or internist get my tests run before the visit. How do they know what to order if you have not talked about what health issues you have -- which occurs at the time of the visit. My internist office always calls me after the visit with any abnormal results and tells me the Dr recommendation regarding the lab test. In my case, it is either keep same dose, increase, or decrease a med.
My endo office does the A1c check within 5 minutes of my entrance and has results by the time I see him.
Oh, and my internist does not believe in annual checkups as he says they rarely are useful.(I did get the one free Medicare one.) He would rather me come in as needed. He does do annual or bi-annual blood tests, depending on the test.

Sorry I am rambling. This just seems unusual to me but then I may be in the minority. Would like to know if I am.

I'm a T1 and have labs drawn the week before I go in for visits. I am fairly new to D just a year and a lf since dx at 60,and I'm on pump and CGM. I get seen every 3-4 months alternating between pump nurse and endo. I always get my orders for next set of tests placed by practitioner I see so they are available for review with next visit. They keep track of what needs reviewed based on current numbers and testing protocols.
Also review meter, pump and cgm downloads at visit to see how things are going, see if things need tweaked, see if numbers/insulin requirements are shifting.

My D care is with Endo not with PCP, as they have little to no experience with adult onset T1. I was the first seen/recognised in the practice - not to say that they might not have missed others, especially as I was the one that came in with the list of what to order and twisted arms to get it all done.

Am seen in a large teaching hospital diabetes center in the Philadelphia area with lots of T1 experience.

I am a T1 also. My endo only deals with diabetes (+ thyroid in my case) so the only tests he runs are A1c and thyroid tests on a periodic basis. I get the same meter and cgm downloads at the visit as you and we go over all of that & the A1c at the visit. I am not sure what tests you get done before the visit but my endo office runs the A1c test in minutes so it is not necessary for me to get blood drawn ahead of time. Maybe you get different tests than I.

I get mine done after the visit, but then I see a PCP and am not looking for any input from her on my D management. If anything else needs attention, she calls me. But if you have a doctor you want to go over things with then yes, before does make more sense!

I know you're all sick of my saying how it worked when I lived in Guatemala, but I would just go to any lab, order any test (they had heard of), go back two days later and get the result. It was then up to me (based on my own knowledge or anything flagged by the lab) if I wanted to bring it to a doctor to discuss.

My insurance used to allow tests before doc visit then required visit before test and is now back to tests before visit. It does make sense to have normal battery if seeing doc for known condition. I think it's necessary to have a discussion with doc. Otherwise, it's over the phone. Another thing that burns me to no end is I can't get a copy of lab results unless the doc writes on the order that I get a copy. They usually forget. I want a copy to share with other docs that I see. like my cardiologist.

One more note on Deborah's point. In your case, I would request at least the A1c early enough before the visit so that you can talk with your internist about it. I definitely think that you need at least the A1c for the visit. Of course, you are already planning to do this so am just underscoring the value for it.

One advantage of the practice I see is that it is a large hospital based practice and they have a system wide online service that lets you access all records regardless of the service you saw as well as access all your testing results. It also allows online messaging to your clinicians so non emergent questions and prescription refill requests are easy to do without having to wait forever on hold.

Getting appointments to any service can also be handled on line, with a minimum call back time of 24 hours. And since it within walking distance of my work place can get seen first thing in AM, or during lunch break etc.

Zander, if you are in the U.S. you do not need a dr order to get a copy of your test reports. I just ask the receptionist or tech for it and they give me as many copies as I want (for self + other docs). If my tests have to do with another test (cat scan, cardiac tests, etc), I just sign a paper at checkout for my request and they mail it to me. That is the law. It is your medical record. I did not check your location.

Oh I am with you! I think it's just plain stupid to not want blood work done before a visit to the doctor. I'd be calling again to demand (if you have to get that forceful) a requisition for blood work! I always get it done a week or so before my appt.

I live in Ontario, Canada and get my A1C blood work done a week or so before my appt.

I am in the US, CT, and have asked the lab more than once and am told they can't send me a copy without doc's permission. With a written order, I just put copy to "patient" no problem. Most now are using electronic orders to lab. I have had a couple MRIs, and they give me a CD with images before I leave. Go figure.

I too have always been told the doctor needs to note "copy to patient". They will not give you a copy if that isn't there. It is ridiculous, you should have a right to your own labs, but it seems to be the way things are done in anyplace I've ever been. Could it perhaps vary by state, Nell?