There Will Be Blood

Welcome, haematic reader, as this week I highlight some of the obvious differences between how we think about healthcare in the US and the UK. I've written about some of these before, with regards to organization, centralization and cost, but here I want to discuss some of the differences in transparency and how that reflects the general attitude to the rights of the individual.

A fairly standard medical diagnostic tool is the humble (or maybe not so humble) blood test. In the UK, you'll typically only have a blood test if there's something wrong with you that needs diagnosis, or some ongoing medical condition which the professionals want to monitor. You'll make an appointment, you'll go and see someone, they'll take some blood, send it off to the lab, and you'll get the results several days or even weeks later. And when I say "results", you won't see the raw data: a medical professional will look at the raw data and then explain to you if there's anything you need to do about it. And generally that will be to eat a bit more fruit and veg, get some exercise, make sure you're sleeping properly.

Here in the US, the attitude is entirely different: screening is a way of life, so an annual blood test for various different things is common, whether you have symptoms or not. You take that test by turning up at the lab - no appointment required or even possible - and having your blood taken there and then. The results turn up in an app on your phone in real time, sometimes as little as an hour or two later. Perhaps most starkly different is that the "results" really are your raw data, completely uninterpreted. The process of taking the blood might be industrialized and highly efficient, but when it comes to working out what it means, I guess that's down to you and Dr Google. So it's with great excitement that I can tell you that my LDL cholesterol level is 95 mg/dL, described as "optimal" by the phone app, and that somehow that's lower than Helen's.

It's also worth noting that, because I'm lucky enough to work for a company with a lot of money, this is about the highest standard of healthcare available here in the US. If your insurance isn't as good, or you're unemployed, then your experience doesn't look anything like this.

So is this better or worse than the UK? The proponents of the US philosophy would argue about transparency, patient choice, and the effectiveness of screening. Personally I think it's more likely that I'm going to end up self-diagnosing something silly based on a misinterpretation of data as a result of having it at my fingertips; I'd rather have someone with some actual medical training telling me what to do with all this data. But on the other hand, there's a point of view that says people have had enough of experts, and maybe they just want to be their own doctors. I think this is fairly obviously nonsense, along with everything else Michael Gove says, but each to their own.

We finally have some news about the re-opening of our local heritage cinema, the Stanford Theatre. It's opening up next week:

Obviously I'm waiting with baited breath on those full blood test results so I can see if I'm well enough to go, or whether I've got some apparently symptomless, hitherto undiagnosed condition that might make attending the cinema hazardous. Wish me well, dear reader!