Testing categories in practice — clinical conversations

The conversation centers on colorectal cancer screening, at-home COVID and flu testing, and fertility testing, with McPhillips and James 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 also 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 and flu testing, sharing a case where an at-home positive test let a pharmacist quickly get an immunocompromised patient on Paxlovid, and suggest that these encounters double as natural vaccine counseling opportunities.

The discussion then turns to two areas requiring more caution: UTI testing, where results can jump-start treatment but shouldn't replace culturing or physician follow-up, and fertility/sperm quality testing, which the pair frame 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.