Every year I buy comprehensive blood testing from Walk-In Lab during their 20% off, end-of-the-year sales event. I select the test, pick the lab (Lab Corp or Quest Diagnostics) and pay online. I take the lab order to Quest Diagnostics located in my local Walmart. Nothing could be easier; I can even shop while I wait for them to call me for my blood draw. Prices are transparent. Lab tests that I paid just under $130 for on sale would possibly cost $500 through the hospital owned clinic that employs my doctor. Whenever I see a doctor, I always bring along the results from the previous tests.
What is better than a lab up the street in Walmart? The laboratory in your own bathroom. John Goodman already posted about a Washington Post article on in-home DIY medical testing, but it’s so good I want to discuss the implications in greater detail. Nothing boosts patient power quite like the ability to take charge and do it yourself. Nothing increases convenience like avoiding the doctor’s waiting room and doing it at home or on the phone. My HSA makes it affordable.
Covid gave telemedicine a jumpstart when patients could not see their doctors in person. Online clinics that use telemedicine to treat patients remotely represents a new, more convenient and transparent way to receive care. Covid also helped spur progress on in-home medical testing, which goes hand-in-hand with telemedicine. I suspect opaque pricing and sky-high health insurance deductibles helped boost in-home testing as well.
In-home testing could also lead to better medical care, more convenient medical care and cheaper medical care. As it now stands, I have a significant transactions cost to even inquire about a potential medical service. I must see my doctor about anything. My wife just got back from the doctor as I was writing this. She complained about the 70-mile roundtrip just so her physician’s office would renew a medication she has been using for years. Her old NP retired, and she caught flak from the new PA she saw, who refused to go along with the status quo. She would find a new doctor closer to home but that is a huge hassle. From the Washington Post:
A new world of DIY testing is changing the relationship between physicians and patients, allowing people like Sharma to bypass the doctor’s office and take medical tests on their own. Buoyed by a growing network of independent labs, Silicon Valley start-ups now offer tests for a battery of conditions including menopause, food sensitivity, thyroid function, testosterone levels, ADHD and sexually transmitted diseases.
Surveys find that nearly 40% of Americans have digestive issues. I have run across numerous people who complained of having some degree of gastrointestinal problems. Virtually all said their doctors offered little help. Most were probably too embarrassed to ask. The Washington Post has an example:
An array of basic first foods — from bananas to sweet potatoes — caused her 6-month-old Annika to vomit uncontrollably…Half a dozen pediatric specialists largely dismissed her daughter’s ailments, Sharma said, forcing her to leave her job as a hospitality executive, because “you can’t just have any babysitter looking after a child” with such serious reactions to food.
Sharma, Annika’s mother, finally found the answer in a Facebook advertisement. Silicon Valley startup, Tiny Health, could test her daughter’s microbiome, which turned out to be overpopulated with P. vulgatus. A nutritionist recommended simple dietary changes that cleared up her daughter’s condition within months.
Sharma credits Tiny Health’s gut-biome test, which was developed by a Mayo Clinic microbiologist but not approved by the FDA, with providing “a mind-blowing tool you can’t get from the traditional medical establishment.”
I wrote about the emerging self-care trend nearly 20 years ago in Consumer Driven Health Care: The Changing Role of the Patient. My predictions are finally coming to pass.
Yet the draw of these companies is that they offer options to those feeling let down by conventional doctors.Patients said the testing industry offers a rare path to relief, but many see a dangerous Wild West of medical information.
The physicians whose offices patients hope to avoid are not always fans of more convenient diagnostic testing. One thing that worries some medical providers is the bevy of charlatans on TikTok promoting questionable medical treatments. One solution is to just avoid sketchy medical advice from social media.
The health care system’s business model has been largely unchanged for 70s years and it is about time for some disruption. One major change is not a good one; 75% of physicians now work for a hospital or an investor-owned group practice where doctors are pressured to maximize revenue.
I look forward to a world where doctors are only a few clicks away on a website and in-home diagnostics tests increase both convenience and patient power.