"I'm afraid there's a growing sense that testing is the way to health," says Dr. H. Gilbert Welch, an internist at the Dartmouth Institute who has written books on the pitfalls of overdiagnosis. Encouraging sufferers to order their own blood tests feeds that mindset, he says.TEK Image/Science Photo Library/Getty Images hide title
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"I'm afraid there's a growing sense that testing is the way to health," says Dr. H. Gilbert Welch, an internist at the Dartmouth Institute who has written books on the pitfalls of overdiagnosis. Encouraging sufferers to order their own blood tests feeds that mindset, he says.
TEK Image/Science Photo Library/Getty Images
An aspect ofdropsof Theranos is the use of the blood testing company's do-it-yourself ethic to promote its product. Theranos offers consumers aMenu with more than 200Inexpensive diagnostic blood tests for a variety of medications, conditions, deficiencies and diseases.
In about two dozen states, it's legal to order blood tests without consulting a doctor. But should you?
Theranos and some other medical companies say yes, while critics argue it's a recipe for disaster.
Here is the founder of Theranos,Elisabeth Holmes, at TEDMED in 2014, laced up the bootpresentationwith the ideals of patient self-empowerment.
"My own life's work in building Theranos is to redefine the diagnostic paradigm, away from one in which people must present a symptom in order to access information about their bodies," he said, "to one in which every person, no matter how much money they have or where they live, has access to actionable health information when it matters."
He also brought an absurdity to the crowd:
“(Today) I can buy an exotic and deadly animal, a venomous snake, a military truck, or an armored vehicle. I can buy a tank... but I can't order a blood-based pregnancy test or a test for allergy becauseTheit could be dangerous."
An inspection by the federal government last yearfoundthat shortcomings in Theranos' laboratory in California "could immediately jeopardize the health and safety of patients". The company is currently awaiting the Centers for Medicare & Medicaid Services to make a final decision on whether to lose its license to operate its laboratories.
But for now, Theranos is still testing its wellness centers at dozens of Walgreens and other locations in Arizona, as well as one in California.
Theranos isn't the only company offering blood tests for sufferers.WellnessFXhas a long-standing association with Quest Diagnostics medical laboratory; Consumers in all but seven states can use the WellnessFX website to order their own "biomarker" tests online, along with more traditional thyroid function, blood glucose, or testosterone tests.
Like Theranos, WellnessFX has embedded the ideals of patient access and independence into its marketing campaign.
"A lot of the data that can be used to understand what's best for the patient has historically always been the clipboard handed to the doctor ... and it was never actually shown to the patient," said WellnessFX co. -Founder Brent Vaughan in 2013promotional video. "Because there has always been a belief that patients either cannot or do not want to understand this information."
a growing trend
Last year, medical diagnostics giant LabCorp plunged into the do-it-yourself diagnostics waters by allowing Arizona consumers to order their own tests. Lab CorpCEO David Kingsaid in an email that the company's market research shows that a "significant percentage" of consumers are interested in trying it themselves. The company plans to expand the service to other states later this year.
"As consumers pay more of their health care costs out-of-pocket, they should and will become more involved in the management of their health care," King said. "We absolutely support them in this."
Last April, when the state of Arizona enacted its law –pushed by Theranos- Giving consumers the ability to order their own tests passed the House 60-0 and the Senate 26-2.Senator Steve Farley, a Democrat, was one of the "no" votes. The collapse of Theranos does not surprise him.
"We were really asked in this bill to allow our Arizona constituents to become beta testers and use their own bodies as a tool for that beta test," he said. (Theranos declined to comment.)
The debate over the wisdom of removing physicians from the diagnostic cycle has raged for years. Some scholars have expressed reservations.Dr. Norman Paradis, an emergency room physician and medicine professor in Dartmouth who has consulted with diagnostic startups, calls the model of offering a wide range of tests, as Theranos does, a recipe for disaster.
"If you simply test a large number of people who don't have signs and symptoms of a particular disease, many of the results will be false positives," he explained.
And those patients could end up falling further down the rabbit hole of more invasive and potentially harmful tests and treatments.
Paradis said it's quite difficult to get medical students and even medical professionals to order tests properly. "So if it's hard for them, it's even harder for lay people."
Dr. H. Gilbert Welch, internist at Dartmouth Institute and author of severalBooksabout the problems of overdiagnosis, thinks doing your own blood work is part of itNegative trend— Judge people who are not actually ill.
"I'm afraid there's a growing feeling that the road to health is through testing," he said. "But health doesn't prove itself. Health is much more about how you exercise, what you eat and how you find joy and meaning in life."
WellnessFX has addressed concerns about false positives, it saidDr. Murdoc Khalegi, emergency physician and company medical director. He said the company is working with doctors to ensure the tests it offers are not prone to inaccurate results.
“We work very hard to offer tests that a consumer can understand, such as B. high cholesterol or high blood sugar,” said Khalegi. “We encourage sharing all of our results with clinicians. But it would be unfortunate to prevent people from having this information as it currently exists in some environments. People need to know if they have certain health risks.” .
The Center for Democracy and TechnologyMichelle de mooy, who has researched the issues of privacy and transparency in healthcare, rejects the argument that patients cannot make informed decisions about when to get tested. She said the problem of false positives is being "reasonably addressed" with alerts.
Both she and Khalegi point to high healthcare costs as a reason for giving patients more direct access to diagnostic tests. It is often cheaper for the patient, they say. Health insurance with high deductibles or no access to transportation or childcare are reasons people choose to get tested in the most efficient and time-consuming way.
"The issue of economic inequality is something that healthcare organizations tend to overlook," De Mooy said.
A patient's story
Amy, who lives in Santa Cruz, California and asked us not to use her last name to protect her medical privacy, explained why last year she was motivated to go online to order her own test for iron deficiency anemia, although this was the casefeel healthy.
The US Preventive Services Task Force does not make any recommendations for testing for iron deficiency anemia in asymptomatic individuals. But Amy is vegan, and some of her friends persuaded her to look for evidence that it's possible to eliminate meat and dairy from your dietincrease riskin iron deficiency anemia.
And because of the high deductible on her health insurance and alleged bad experiences with insurance companies, Amy didn't want to go through her health plan.
According to the test result, his iron level went down to a low value. But instead of starting an iron supplement, changing her diet, or taking other steps on her own, she made an appointment with a doctor, to whom she mentioned that she had donated blood a week before the test. Little did Amy know that this would deplete her iron. And since her other numbers were fine, the doctor told her not to worry.
The entire experience was painless and reassuring, despite the blood draw, Amy said.
“I liked answering my own questions and going on the site and picking what interested me. I like being able to do this independently as I don't have a GP to go to.”
Somehow, Amy fits the profile pointed out by both proponents and opponents of self-assessment: She had no symptoms of anemia and a test that ended up being unnecessary. But he also felt he had a psychological need to know and a financial need to find the answer at low cost.
WellnessFX's Murdoc said that while Amy is following official medical testing guidelines, he probably did the right thing by testing for anemia.
"It's a very cheap blood test," he said.
This story was produced by KQED's daily health and technology blog,future of you.The host and publisher of the blog isJon Brooks.
FAQs
Can a patient order their own lab tests? ›
Yes, you can order your own blood tests in California, depending on the test. As per a law passed in 2001, Californians do not need a doctor's prescription to get blood tests for glucose, cholesterol, pregnancy, occult blood, and HIV (FDA-approved home-based blood collection kits only).
Are at-home blood tests worth it? ›Multiple studies have found that self-test kits do not live up to the accuracy claims made by manufacturers. An evaluation of 20 tests (including home, send-away, and genetic tests) found that only three could be recommended on the basis of scientific evidence.
What are the disadvantages of blood tests? ›- What are the risks? It is very rare for a blood test to result in serious complications; however, there is a very small possibility of complications arising.
- Infection. ...
- Excessive bleeding. ...
- Bruising. ...
- Fainting and dizziness. ...
- Haematoma.
Lab tests can help your doctor be sure that your medication or treatments are staying effective. Changes in your labs or symptoms may also indicate the need to bring in a specialist to help with your care.
Can patients order their own labs on LabCorp? ›Labcorp OnDemand lets you choose from a suite of health tests with the click of a button. And with thousands of lab locations, your science-backed answers are never far from home.
Can I order my own labs from Quest? ›With Quest, you hold the power to purchase lab tests for yourself. No doctor visit required. Log into MyQuest® to book or reschedule a lab visit, view test results, and more.
What is the best blood test for overall health? ›Chemistry Panel and Complete Blood Count
The Chemistry Panel and Complete Blood Count (CBC) is the best place to begin your disease-prevention program. This low-cost panel will give you and your physician a quick snapshot of your overall health.
Blood tests can be used for many different things, including to check cholesterol and blood glucose levels. These help monitor your risk of heart and circulatory diseases and diabetes, or how your condition is being managed. Tests for different chemicals and proteins can indicate how your liver or kidneys are working.
What blood tests test everything? ›Complete blood count (CBC) is one of the most commonly ordered tests, and for good reason. Your blood cells can tell a lot about your health. CBC lets you and your doctor know when you have issues with infections or inflammation, but it will also signal when your diet is not balanced.
How often are blood tests wrong? ›A proactive approach can help lower your risk for misdiagnosis. It is estimated that seven to ten million patients receive an inaccurate blood test result annually. Approximately 35,000 labs run high complexity tests.
What are the pros and cons of complete blood count? ›
The major advantage is that the trained observer can note subtle differences in WBC morphology and report additional changes in RBC morphology and platelets. The major disadvantage is the need for a trained person to spend increased time (with increased cost) to scan the smears.
How reliable are blood tests? ›The test method can be trusted because results are reliably reproduced time after time. Although a test that is 100% accurate and 100% precise is ideal, in practice, test methodology, instrumentation, and laboratory operations all contribute to small but measurable variations in results.
Do doctors make money from ordering tests? ›Most of your healthcare providers do not earn any profits based on your medical testing. Kickbacks or commissions, where a laboratory or facility pays a healthcare provider for referrals, are illegal in most states in the United States, although there are certainly examples of fraud.
What is the danger of ordering too many laboratory tests? ›Overordering of laboratory test, while previous results are still valid, can have multiple negative effects including increased costs [3], causing unnecessary discomfort to patients [4], and an increased chance of false-positive results [5].
What is the most common blood test ordered for a routine medical check up? ›Complete blood count (CBC) The complete blood count (CBC) is one of the most common blood tests. It is often done as part of a routine checkup. This test measures many different parts of your blood, including red blood cells, white blood cells, and platelets.
How long is blood work prescription good for? ›Most test orders are valid for at least six months (unless your doctor has specified otherwise). If your lab testing order is more than six months old, please contact your doctor for a new form.
Can I go to Quest Diagnostics instead of Labcorp? ›If your provider does not participate with Quest Diagnostics or LabCorp, you may take your lab order to the nearest Quest Diagnostics or LabCorp facility to have your labs drawn.
What is the difference between Labcorp and Quest? ›Labcorp may be the better choice if: It has a more convenient location in your area. Your insurance is accepted by Labcorp but not by Quest Diagnostics. The nearest Labcorp location has a better rating than the nearest Quest Diagnostics location.
Do doctors call right away with bad test results? ›If a result is sufficiently abnormal to cause any immediate medical concerns the doctor will contact you themselves. If a doctor wants to discuss a test result where there is no significant level of concern, they may ask reception to book you in for a routine telephone call.
How long does Quest blood work take? ›If you purchased your own tests from Quest, your lab test results will be delivered to your account as soon as they are available. This is generally 2-5 business days from the time the sample is received, depending on your test.
Who owns lab Quest? ›
| Type | Public company |
|---|---|
| Founder | Paul Brown |
| Headquarters | Secaucus, New Jersey, U.S. |
| Area served | United States Brazil Mexico |
| Key people | Jim Davis |
While FBS tests can still play an important role in your health, the hemoglobin A1C test provides a more comprehensive picture of what your blood sugar, health risks, and longevity look like. With this information, you can take better control of your well-being and live a healthier, happier, longer life.
What should you not do before a blood test? ›- Avoid drinking or eating anything for 8-12 hours before the test. ...
- You should not eat 3 hours before the clinical blood test.
- Eat less fatty and fried food, and avoid alcohol 1-2 days prior to the test.
- Don't smoke 1 hour prior to the test.
...
What cancers are detected by blood tests?
- Hodgkin lymphoma.
- Leukemia.
- Non-Hodgkin lymphoma.
- Multiple myeloma.
They test the blood for white blood cells, red blood cells, hemoglobin, hematocrit, and platelets. CBC tests can detect if you have anemia, nutritional deficiencies, an infection, cancer, and bone marrow problems. If any of these results come back as abnormal, your doctor may order more specific testing.
Do all infections show up in blood tests? ›Germs that do not grow in lab cultures: Certain types of bacteria, fungi, and viruses are difficult or impossible to grow in the laboratory. A person infected with one of these germs can have a negative test result even when they have an infection.
What percentage of blood tests are wrong? ›About 50-60 percent of all blood tests and skin prick tests will yield a “false positive” result. This means that the test shows positive even though you are not really allergic to the food being tested.
What blood tests should a 70 year old have? ›- Complete Blood Count (CBC) The first panel commonly used in laboratory blood testing is a Complete Blood Count (CBC). ...
- Basic Metabolic Panel (Basic Electrolyte Panel) ...
- Comprehensive Metabolic Panel. ...
- Lipid (Cholesterol) Panel.
A blood test is typically composed of three main tests: a complete blood count, a metabolic panel and a lipid panel.
What blood test should I get every year? ›Bottom Line. Many doctors recommend that you get blood work once per year, during the time of your annual physical. The three essential lab tests are routine blood work, A1C testing, and a lipid panel. These tests can provide a comprehensive insight into your current health status.
Can you have too many blood tests? ›
Repeated blood tests cause progressive scarring to your veins. Some people, especially those with kidney disease or diabetes, need a lot of regular blood tests, and their veins can get damaged over time.
Can you get a false reading from a blood test? ›Approximately 1/3 of all Positive Blood Cultures are FALSE Positive Blood Cultures. Research suggests that approximately 90% of all blood culture tests have negative results. That means that for every 1000 blood draws, about 100 patients receive a positive result.
Can blood test results change in a month? ›It's not unusual for blood test results to vary from time to time or lab to lab, but even blood taken at the same time and measured by the same lab can generate slightly different results. Some factors, such as differences in lab equipment and processes, are out of your hands.
How often should you get a complete blood count? ›A Complete Blood Count (CBC) checks red blood cells, white blood cells, and platelets. This type of blood work is most often used to identify conditions such as anemia, heart disease, autoimmune diseases, leukemia, and other cancers. Everybody, regardless of risk factors, should receive a complete blood count annually.
What is the difference between a full blood count and a complete blood count? ›A full blood count (FBC) is a very common blood test that is also sometimes called a complete blood count (CBC) or full blood examination (FBE). It is a test for general health, but it can also provide information about a range of conditions.
Do you really need blood work every year? ›Doctors recommend patients have routine blood tests at a diagnostic testing center at least once a year, at around the same time as other physical examinations. Medical practitioners require it to monitor your condition and detect illnesses early on.
Are home blood tests any good? ›Multiple studies have found that self-test kits do not live up to the accuracy claims made by manufacturers. An evaluation of 20 tests (including home, send-away, and genetic tests) found that only three could be recommended on the basis of scientific evidence.
Why do doctors push tests? ›First we need to understand why doctors order too many tests. The most commonly cited reason is "defensive medicine": the fear of being sued by patients for not ordering a test. Recently, new evidence of defensive medicine was presented at the American Academy of Orthopedic Surgeons conference.
How many medical tests are unnecessary? ›Studies looking at testing of patients have found 40%−60% of tests to be unnecessary. Unnecessary tests can cause patient discomfort, patient harm, and increase health care costs.
Can a doctor deny me a blood test? ›In most cases yes. You must give your consent (permission) before you receive any type of medical treatment, from a simple blood test to deciding to donate your organs after your death.
What is the most common lab error? ›
The most common lab errors in the collection of the samples and reporting are: Wrong labeling of the sample. The technique of the blood sample: This is very important to follow an excellent technique to collect good quality blood.
How common are lab errors? ›By this definition, failures in laboratory tests certainly qualify. Lab test failures contribute to delayed or wrong diagnoses and unnecessary costs and care. For context, a 2014 study estimated that diagnostic errors happen about 12 million times per year in U.S. outpatients. This represents 1 in 20 adults.
What are the four legitimate reasons to order a lab test? ›- Are you in need of a doctor's appointment? Do you have an issue that you want a doctor to diagnose? ...
- Diagnose Diseases. ...
- Screening. ...
- Monitor the Course of a Disease. ...
- Check Overall Health.
Although not specifically for heart problems, some routine blood tests can provide valuable information about your overall health — including your heart: Complete blood count, or CBC: measures levels of different components of your blood.
How long should you wait between blood tests? ›If the maximum amount of blood is drawn on one occasion, we recommend waiting about 3 weeks between blood draws to reduce the risk of anemia or other abnormalities. For experiments that do not require the suggested maximum blood draw, blood can safely be drawn more frequently.
Who is authorized to place an order for a laboratory test? ›In order to be considered a “representative” of the healthcare practitioner, that person must work for a person authorized to order tests, such as the ordering practitioner's physician assistant or registered nurse.
Who can legally order lab tests in California? ›Only a licensed physician and surgeon, a licensed osteopath, or a licensed doctoral scientist can direct a laboratory in California. However, the director of the laboratory of an acute care hospital must be a board certified pathologist.
Who can order lab tests in Oregon? ›All laboratory tests in Oregon require an order from a medical doctor (MD), doctor of osteopathy (DO) or other "Authorized" individual, except non-medical substance of abuse screening and health screen testing performed by a laboratory with a Health Screen Testing (HST) permit or Substance of Abuse Registration.
Who can order lab tests in Pennsylvania? ›In the state of Pennsylvania only certain licensed health care professionals, such as your physician, can order laboratory tests. Lab test results are used along with a physical exam and other diagnostic tests to make judgments about your health.
Does lab draw order matter? ›Blood samples must be drawn by phlebotomists in a specific order to avoid cross-contamination of the sample by additives found in different collection tubes. Phlebotomy order of draw is the same for specimens collected by syringe, tube holder, or into tubes preevacuated at the time of collection.
Is a lab requisition the same as an order? ›
What is a lab requisition (doctor's order)? Requisition refers to physician's order/doctor's order/lab order. A physician order is an authorization for you to have lab testing performed. It's similar to a doctor providing a prescription for medication.
What is a standing order at Labcorp? ›Standing Orders: These tests are those that your health care provider wants you to complete on a regular basis, or as needed (also known as PRN). If you see the words “Interval” or “Remaining”, this means that it is a standing order.
Can I have my own laboratory? ›Yes definitely you can open up your own laboratory however you must process all required licenses and have seeious budget for the same. First analyse and weigh the costs and only then go for this route a sits time consuming and cost too is high for setup as per location and licenses.
Do I have a right to my lab results in California? ›' ” Gaining access to medical records shouldn't be so hard for patients. Under both a federal law known as HIPAA (Health Insurance Portability and Accountability Act) and California state law, consumers have the right to access records documenting their health conditions, diagnoses and treatments.
Why is online lab testing prohibited in NY? ›New York law requires that laboratory tests be performed only at the request of licensed medical providers within their scope of practice. After Schneiderman's office investigated the arrangement between DirectLabs and LabCorp, it ordered the operation to be shut down in March 2015.
What's the difference between Labcorp and Quest Diagnostics? ›Labcorp may be the better choice if: It has a more convenient location in your area. Your insurance is accepted by Labcorp but not by Quest Diagnostics. The nearest Labcorp location has a better rating than the nearest Quest Diagnostics location.
Can I go to Quest Diagnostics instead of labcorp? ›If your provider does not participate with Quest Diagnostics or LabCorp, you may take your lab order to the nearest Quest Diagnostics or LabCorp facility to have your labs drawn.
Can I go to labcorp without a doctor? ›Purchase a test on OnDemand.Labcorp.com
Shop for tests on OnDemand.Labcorp.com and pay online. We do not bill insurance. An independent physician will review and approve your test requests; no doctor's visit is required.
Most test orders are valid for at least six months (unless your doctor has specified otherwise). If your lab testing order is more than six months old, please contact your doctor for a new form.
How long does labcorp blood work take? ›In most cases, lab test results delivery times should not exceed two weeks. The most common reason for delay in receiving results is inaccurate or out-of-date personal information on record with your health care providers or in your Labcorp Patient™ portal personal profile.
Which blood tests take longest for results? ›
...
The following Blood tests will take longer:
- Diabetes blood test (Hba1c) – 1 week.
- Rheumatoid Arthritis blood test – 1 week.
- Coeliac blood test (endomyssial antibody) – 2 weeks.
- Vitamin D blood test – 3 weeks.