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Patients go to the doctor all the time, coughing, sneezing, and with a sore throat. Most times, the provider diagnoses the patient with an upper respiratory infection with no need for lab work or imaging. Other times, lab work is ordered, which means a Basic Metabolic Panel (BMP) or a Complete Blood Count (CBC). The results are important for the physician, but patients always want to know, too. When this happens, it’s important for medical assistants to know his or her role when it comes to understanding, reporting, and communicating the results.
What to Do with Abnormal Results
In many cases, the physician receives the results and has assessed them for changes or abnormalities. However, at some medical facilities, medical assistants are the first to see the data, and can point out potential problem areas to the physician before he or she sees the patient. Here are the normal ranges you may see and check against:
- Sodium: 135 – 148 mEq/L
- Potassium: 3.5 – 5.5 mEq/L
- Chloride: 96 – 112 mEq/L
- Bicarbonate/Carbon Dioxide: 21 – 34 mEq/L
- BUN: 6 – 23 mg/dL
- Creatinine: 0.6 – 1.5 mg/dL
- Glucose: 65-99 mg/dL
- Hemoglobin: Male: 14 – 18 g/dL, Female 11 – 16 g/d
- Hematocrit: Male: 39-54%, Female: 34-4%
- White Blood Cells: 3.8 – 11.0 10^3 / mm3
- Platelets: 140,000 – 450,000 /ml
Let your provider know if you notice any crazy variation. Part of being a medical assistant is attention to detail. The patient you’re taking care of at the moment is your responsibility, too, and it’s important to keep an eye out for the laboratory values, too.
Communicating with Patients
Occasionally, the physician calls the patient to discuss their lab work, or asks them to come into the office. Other times, the medical assistant will briefly educate the patient on their lab work, with permission from the provider. It’s important not to give information to the patient unless given the go-ahead from the physician. This is extremely vital to remember. When becoming a medical assistant, one of the first things you’ll learn is that you should not diagnose patients or give them information on blood work, imaging studies, biopsy results, or anything of that sort unless told by a provider that it’s okay. Why is this important? Two problems can occur if you’re not careful:
1. Telling a patient their results are NORMAL, and then the physician realizing that something is off takes away a lot of trust from the patient. The doctor-patient relationship is one of the most important aspects in healthcare. This relationship keeps patients taking their medication and prevents lawsuits. So telling the patient their levels are normal, and then backtracking to say, “Oh, actually Mrs. Jones, your blood sugar is high and we’re going to have to start you on insulin,” is not great for the patient or the practice.
2. Telling the patient that they have ABNORMAL results without the doctor on board may scare the patient, make them feel uncomfortable, and worried. It is best for the doctor to tell patients about abnormal results, in face-to-face encounters, in safe environments, with a plan on how to proceed. There is an algorithm for how to break bad news to patients, even, called SPIKES. It’s best for the patient to hear both good and bad lab results from the physician, but if you as the medical assistant are tasked with this, it’s helpful to know how to handle it.
When Patients Get Nervous
Patients can get nervous about their lab work. They might not have been educated on why they needed to have their blood analyzed and will question what their results mean. It’s helpful to ease patient’s anxiety by explaining that this was a routine test that was done as part of the physical examination, to get a baseline for their values, or to understand if there was a specific reason for their illness that could be explained by any aberration in the blood levels of their electrolytes. In the case of everything being normal, you can move on and say something along the lines of “Your blood did not show any abnormalities that the doctor is worried about. If you have any specific questions, we can give you some more information.” Or, if the doctor has time and hasn’t seen the patient yet, there is the chance he/she will be able to give a bit more information. This depends on the day, the doctor’s preference, and their schedule.
Where You Work Matters
As the medical assistant, there is a lot that you should know, and it depends on the practice and the physician you are working with. Busier practices may allow more freedom for the medical assistant to take blood, give a bit of information, and even provide lab results, which the provider will go over with the patient. Other times, the provider will want you to spend as little time with the patient as possible and try not to give away too much information, so that they can come in and discuss everything in person. It’s always better to ask your provider before-hand, learning how they like things done.