[robbiep]

This is a really valid criticism. I often send patients home from the emergency department with values outside of the normal, usually without discussing that finding with them (ie, it is not useful for a patient with some level of kidney failure to know that their sodium is 130, and has been on every presentation they have had for years). Trying to have a conversation with every second patient about why this value is slightly outside of reference and how the reference ranges are actually calculated is not productive and will likely only lead to confusion and obsfucation of the actual reason they presented

[yourapostasy]

The medical community should reconsider the standard policy of not having that conversation. While it may be medically sound practice, the insurance industry takes these reference values as Gospel Truth. Your life insurance premiums and coverage are predicated on how much deviation you exhibit from the reference ranges.

[robbiep]

Only in countries that are allowed to differentiate on the basis of lab tests. Which is not the case where I practice.

If a lab result is outside the normal range and a patient has a reason for it to be outside the normal range, that's fine. If a patient has a deviation that is related to their presenting complaint, that's fine too. If a patient has an unexplained deviation which is not related to the presenting complaint, well, there's a 1 in 20 chance that the variation is statistical only. So you use your clinical judgement. is this a patient who requires outpatient follow-up and repeat, or is this an abberation?

[martingoodson]

Actually, there is a one in twenty chance that a normal person would generate the results in question. Not the same thing.