Traditionally, people get blood tests when a doctor recommends them. This usually happens at the conclusion of an office visit. Nowadays however, people have begun deciding for themselves which lab tests to get and when to get them.
Folks have different reasons for making such independent decisions. Some want to keep track of cholesterol or hemoglobin A1C levels. Others want to assure their blood will screen negative for drugs prior to a job search, test for the presence of a disease like hepatitis C or AIDS, or obtain a chemistry panel that provides a broad picture of their overall health. The biggest reason for consumer-directed lab testing however, is an economic one. Uninsured people, and those with high-deductible insurance plans find it cheaper to do-it-themselves, since it avoids the cost of an office visit.
The savings can add up. A lipid profile (including cholesterol levels) obtained from an online lab testing company costs about $40. A hemoglobin A1C test usually runs a bit less. A visit to the doctor’s office typically costs $150 or more.
Although hundreds of tests can be obtained in this manner, the most commonly sought-after tests are lipid profiles, C-reactive protein (a new measure of cardiac risk), liver and kidney function tests, vitamin D levels, and hormone levels including estrogens and testosterone.
Consumers have plenty of ways to get lab tests done on their own. Many simple tests are available at drugstore clinics and health fairs, for example. Those interested in tracking their cholesterol levels over time can purchase either single-use devices for about $15 or reusable devices, usually for under $100.
The real growth in the do-it-yourself lab market however, involves online testing services such as HealthOne, Direct Laboratory Services, Health One, Personalabs and PrivateMD Labs.
According to one report, people spent nearly $20 million for lab tests through companies like these last year, and annual growth of 15-20% is expected in the next few years (although these projections may seriously underestimate demand if newer, lab-on-a-chip technology continues to develop. This technology promises to cut waiting times for lab test results from several days to less than 30 minutes, a feature that will surely capture the imagination of health consumers).
These Web-based companies permit consumers to order lab tests online. They contract with national laboratories like LabCorp to draw the blood and run the test. The firms usually have staff physicians that sign orders for tests without ever seeing patients. They also help consumers interpret the results, for example by emailing them with recommendations to see a doctor if their results fall outside normal ranges and by phoning anyone whose results suggest a serious abnormality.
A Word of Caution
All this is fine and good so long as consumers remember that lab results need to be evaluated in a larger clinical context. A mildly elevated cholesterol level means one thing in an otherwise healthy individual, and quite another in somebody who has multiple cardiac risk factors. As well, various factors influence test results and hence, the way these results should be interpreted. For example, an elevated C-reactive protein level can suggest increased cardiac risk, but it also can be caused by non-cardiac factors like a winter cold or some other minor infection. It’s always wise to consult a physician or another trained provider when it comes to interpreting lab results.