If doctors had gone purely by the results of the scan taken for the 23-year-old, he might have received treatment that may have been unnecessary. It took about three rounds of scanning at different centres before establishing that all he needed was some rest as he had been working from 6 a.m. to 11 p.m. a day for months together.
However, the young man had a harrowing experience running from one diagnostic lab to another, not knowing what was wrong with him. “It was all because the interpretation of the first scan was wrong. The technician did not get it right, and the doctor did not verify either,” says Chandra Vijayaraghavan, an expert in quality control of drugs, who was earlier with The King Institute of Preventive Medicine and Research.
There are no standards in testing and no regulatory body that keeps a tab on quality in diagnostic labs, she says. Observing that a good medical laboratory is one that has its technicians and equipment periodically assessed, Ms. Vijayaraghavan says: “The absence of standardisation and cross-checking in diagnosis using testing or scanning is a serious concern in the practice of medicine today.”
According to Chennai Corporation sources, there are about 250 laboratories in Chennai. However, a quick search on the internet for diagnostic labs in the city throws up over three times the number. The Corporation is not involved in approving or licensing labs that are being set up. “We recommend that labs register with the Corporation of Chennai, as it is important for notification of diseases,” said an official of the civic body's Health Department.
The absence of a standard, rigorous procedure to certify labs is a matter of serious concern, say experienced professionals in the field.
From authorised equipment to well-trained technicians, labs need to address a series of aspects to ensure quality. “A good lab needs heavy investment. Since we deal with people's health issues, we cannot be careless. We need to constantly monitor equipment and the procedures,” said S. Janardhanan of Premier Health Care. Periodic assessment of equipment and updating technicians' knowledge with regular training is vital.
But there are some private labs that are virtually clueless about quality monitoring by an external agency. “I think we get a group of officials from DMS that inspects us once in every few years, but I am not sure,” said the manager of a private diagnostic lab in Mylapore.
When contacted, an official with the Directorate of Medical Services (DMS) said no specific procedure was in place at the moment and that they were waiting for one.
The lack of standardisation not only raises important questions on the credibility of diagnosis, but also reflects in the charges involved in getting tests or scans done. “A haemoglobin test that costs Rs.40 at one testing centre, costs Rs.60 at another. And many of us are of the mindset that something that is costlier tends to be better quality-wise. Many end up spending a lot on tests,” Ms. Vijayaraghavan says.
“Most doctors have tie-ups with labs. Many of these labs are excellent, but it is crucial to bring all the labs in the city under the purview of one monitoring agency. That is the only way we can ensure quality,” she adds.