There is no doubt that Gamma-Dynacare will be able to perform laboratory tests on samples collected from Muskoka in a professional manner with up-to-date equipment, communications and controls. As a user I will clearly be able to trust the information that we receive. The issue with a change in our Muskoka laboratory services is not about quality of work. The issue is our ability to make useful interpretations of lab studies obtained.

There are those who are concerned that transportation of specimens from Muskoka to Brampton for testing will be disrupted from time to time due to weather. This is clearly going to happen on occasion. At the same time we have in the past had disruption of local service because of machine break downs. We have always been dependent on transportation of specimens to other locations for tests not routinely done in our local laboratory. These are often delayed longer than our southern, big city neighbours are used to.

What we have had locally for some 20 years is a truly integrated laboratory result network. While the rest of the province suffered in a patchwork of laboratory services not communicating with each other, we in Muskoka have had access to almost every laboratory result obtained either through your family doctor, the emergency department, while an inpatient or after seeing a specialist.

We have not had to go to each of these varied locations to obtain the laboratory history. It has been stored in the hospital’s laboratory computer just waiting for us to request the test history of an individual. Now this might not seem like much to some, but for those of us who must interpret the results of tests it has been very special. Many of you may not realize that there is no such thing as a normal test.

There are test results that may lie within the normal range, but for each and every one of us there is a specific normal for any test. This normal can only be determined by reviewing results over time. At our Muskoka Emergency Departments there has been much better interpretation of urgent laboratory results because we always get to see your previous results. Those who come to Muskoka from the city and have no local history do not get the same service. We know when your ECG has changed because we have a copy of the one you had done at your family doctor’s office last fall stored in our hospital laboratory.

So what will be lost in downgrading our local outpatient laboratory services to the provincial model? You will lose integration. We can search the hospital computer, bother your family doctor to look up all your results, call and send release of information forms to Gamma-Dynacare to get your previous profile. But all of this takes time, money and is annoyingly difficult. In the end when you are lying on a stretcher in the Emergency Department on the weekend when all these offices are closed with a normal or abnormal result that may or may not mean something in the correct context there is only one person who will suffer. It won’t be Gamma-Dynacare, the hospital administrators, the LHIN executive, the nurses or doctors who worry about you. No, only you will suffer.  

Oh, and by the way, the province-wide integration of laboratory services that we all hope will come our way will be happening in the larger centres first because of volume, fibre optic cable and density of customers. We will move backward for some time before we see any real integration again.

Brian Murat MD, FRCPC,
Huntsville