Testing categories in practice—clinical conversations

The conversation centers on colorectal cancer screening, at-home COVID-19 and flu testing, and fertility testing, with Ashly McPhillips, PharmD, and Adam James, PharmD, stressing that pharmacists shouldn't shy away from uncomfortable conversations or treat self-tests as a substitute for further care.

McPhillips and James highlight the recently lowered colorectal cancer screening age of 45 and the need for pharmacists to proactively flag this to patients—especially those between providers or managing conditions like diabetes and hypertension—while being direct about collection method education so at-home samples aren't wasted. They extend the same "don't avoid the hard conversation" principle to COVID-19 and flu testing, sharing a case in which a positive at-home test allowed a pharmacist to quickly get an immunocompromised patient on nirmatrelvir and ritonavir (Paxlovid), and suggest that these encounters also serve as natural opportunities for vaccine counseling.

The discussion then turns to 2 areas requiring more caution: urinary tract infection testing, where results can jump-start treatment but shouldn't replace culturing or physician follow-up, and fertility/sperm quality testing, which the pair frames as one of the more sensitive categories pharmacists will encounter. McPhillips describes using a private consultation room and an open, judgment-free approach to these conversations, and both agree the throughline across every test type is the same: guiding the patient to the right next step, not just handing over a result.