Testing made easy
Direct-from-lab medical results can give patients more power, but they might also harm the unwary
Connie Wainwright wants to save time. Rinah Levine is trying to save money. Tina McKee didn't trust her doctor. A cancer patient in Texas is worried about his privacy. Four people, four different reasons, but they all made the same decision: to order their health tests directly from a lab and avoid going through a doctor.
It's not hard to do. "Order any of 5,600 blood tests and save 40-70 percent! Click here to see how!" blares Health-Test Direct's Web site. "Why test with DLS?" asks Direct Laboratory Services on its Web site. "A simple inexpensive blood test could save your life." And even the nation's largest chain of medical labs, Quest Diagnostics, recently jumped into the direct access act with QuesTest. The direct medical testing field is booming. Thyroid, cholesterol, allergies, liver enzymes, cancer markers, blood sugar, hormone levels--tests for all are on the market. Just click, phone, or fax any of these companies with your credit card at the ready, pick a test, and head to an office to have your blood drawn. Within days, the results will be mailed to your home. "This gives me more power," says Levine, 43, a rancher from Coni-fer, Colo., who used HealthcheckUSA to get a complete blood count and a sophisticated thyroid test. "I wasn't getting the answers or tests I needed from my doctor. Plus it's economics. The thyroid panel ordered by my endocrinologist in Boulder cost me $210. The same test through Healthcheck costs $75." Unless your insurance will cover both the doctor visit and lab costs--it won't cover direct testing--this is a bargain.
False security? Quick, confidential, affordable, and service on demand--the opposite of everything we've come to dislike about American healthcare. What could be wrong with that? In many cases, nothing, if you're careful with what you order. But if you're not, you could end up with useless tests, incomprehensible results (do you know whether it's good or bad that your HBG is 15.5?), and literally taking your life in your own hands. False security from an inappropriate test could lead a do-it-yourselfer to avoid needed care. "I worry about someone who orders a cholesterol test when his real problem is hypertension," says James Martin, a family physician in San Antonio. "Cholesterol isn't going to tell him anything about that." But used properly, acknowledges Martin, direct testing can do everything its clients and companies claim.
The recommendation from doctors is simple: Don't go it alone. Doctors, ideally, know a patient well, know the family history, and are familiar with how various drugs and medical conditions can skew lab results. Tests alone don't add up to a good diagnosis. That's why the California Department of Health Services has begun cracking down on direct access. Karen Nickel, the state's chief of Laboratory Field Services, wrote HealthcheckUSA that she was "disturbed to see the full menu of tests offered at your Web site" and that providing many of these tests without using a California physician violates state law. (HealthcheckUSA has, under protest, ceased its California operations.) "You need someone who knows you, who can put all the puzzle pieces together," says Martin.
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