From A Physician’s Viewpoint – The Importance of In-Office Testing
Written by a current client physician
Importance of In Office Testing for Wounds
The importance of receiving accurate and timely results is critical in at-risk patients with foot or leg ulcers. These at-risk patients include:
- Diabetics (many who have poor circulation and or Neuropathy)
- Neuropathy patients (spinal issues, other forms of Neuropathy)
- Patients with poor circulation (Peripheral vascular disease, smokers)
When any of these patients present with an ulcer, the ulcer is typically cultured to determine what type of bacteria are present and the antibiotic that is effective against identified bacteria. Sometimes a commercial lab will take 5-7 days to get these culture results back to us. A lot can happen to a patient in this extreme amount of time. Indeed, the delay in getting actionable results back can allow the following to happen to our patients:
- The patient develops a more serious infection, leg cellulitis, sepsis, uncontrolled blood sugars and requires Hospitalization
- The patient’s ulcer gets larger and/or deeper (sometimes to the bone-Osteomyelitis) requiring Surgical Debridement
- The patient develops Gangrene requiring Foot or Leg Amputation.
- The patient’s medical condition worsens because of the infection and Dies.
We selected advanced testing for our in-office ancillary services to develop a top-of-the-line laboratory, competitive to any reference lab, that allows us to process samples quicker and more accurately than other commercial options. Having in-office testing to get these infectious disease results more quickly can greatly improve our patient care with results that allow us to best choose the proper antibiotic to use immediately on an outpatient basis, avoiding many of the terrible aforementioned outcomes for our patients. It is critical to treat with the proper antibiotic as soon as possible.
Importance of In-Office PCR Testing for Nail Fungus
Accurate and quick diagnosis of toenail infections are also very important to our patient care. First, we must be able to make the determination if the changes in the nail (thickness, discoloration, brittleness, pain) are from nail fungus or other conditions that can appear like nail fungus (Psoriasis, Lichen Planus, Nail injury).
If the symptoms are driven by a fungal pathogen, treatment is arduous. In fact, for most patients, they must take an oral medication for 3 months to treat the fungus. This oral medication is not without side effects. Liver damage is possible, so adjuvant monthly blood tests are required to ensure the medication is not affecting the liver. Thus, accurate and fast detection of the pathogen is massively important before sending a patient down this path of treatment as it is critical to determine if the nail changes are from a fungus or from some of the other medical conditions previously mentioned before starting a patient on this medication that carries risk.
We cannot highlight enough how very important it is in our practice of medicine to determine the type of nail fungus so the proper treatment can start as soon as possible. This is especially true in Diabetics or patients that have poor circulation who are at risk of developing further infections because of the nail damage, ingrown nails, or develop secondary cellulitis.
Patient care in our practice is paramount. We sought to develop and build a lab that would provide us with actionable results, thereby improving our patient care. Technology exists that allows us to better serve patients and we want to utilize that.