For better or worse? Direct-to-consumer lab tests remove the physician 'middle man'

Many consumers are actively searching for ways to take a proactive role in their healthcare. Direct-to-consumer lab tests, which provide at-home tests for hormones and biomarkers — such as vitamin levels, cholesterol and inflammation — empower patients to identify potential health issues before they progress. But they also remove a traditionally integral factor to healthcare tests: the physicians. 

One company that provides such services is InsideTracker, according to The New York Times. This particular company also offers customers the option to send nurses to their homes and draw blood. While the convenience of DTC lab tests may be a plus for consumers, critics worry they lack proper medical oversight and convince healthy people they have medical issues, which could lead to unnecessary tests and treatments, according to the report.

Despite these concerns, the market for DTC lab tests has expanded substantially. In 2015, the market was valued at $131 million, up from $15 million in 2010, according to Kalorama Information data cited by The New York Times.

InsideTracker and another leading DTC lab test company, WellnessFX, said they work with physicians who review all test results, unlike DirectLabs and LabCorp, which were accused of violating a New York state law that requires lab tests to be carried out at the request of licensed medical practitioners, according to the report.

WellnessFX sells packages that range in price from $78 to $988 for analysis of 25 to 88 blood biomarkers, including vitamins, lipids, cardiovascular markers and thyroid and reproductive hormones. The company will then give customers recommendations for supplements, food and exercise based on their results.

However, some physicians, who are virtually left out of the equation in such services, say there is no evidence that this type of monitoring yields meaningful improvements in people's health. The one-on-one, individualized care physicians provide patients can't be replicated in an at-home, do-it-yourself setting.

Pieter Cohen, MD, an assistant professor at Harvard Medical School and an internist at Cambridge Health Alliance, said his principal concern with DTC blood tests was that they screened for too many biomarkers and set seemingly arbitrary ranges for what is considered normal. Then they give less than novel advice.

"The best-case scenario here is you lose your money and then you're reminded to get more sleep and to eat more fruits, vegetables and fish," Dr. Cohen said, according to the report. "The worst-case scenario is that you end up getting alarmed by supposedly abnormal results that are actually completely normal for you."

More articles on physician issues:
MinuteClinic opens clinics inside 8 Maryland Target stores
Leadership exodus, accreditation problems: Arizona Medical Assc. wants UA College of Medicine investigated
Montefiore Health System, United Hospital Fund partner to integrate behavioral health into primary care

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