Where Lab Tests Are Performed

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Through a Direct Access Laboratory

As with home testing, direct access testing (DAT) – also called direct-to-consumer (DTC) testing or patient-authorized testing –has been growing in popularity over the past several years. This is a type of testing in which consumers can order their own laboratory tests without a medical order from their health care provider.

DAT is a reflection of Americans' focus on health and preventive medicine, offering the opportunity for patients to take a more active role in their own health care. Most states in the U.S. permit direct access testing to some degree. See the Genetics and Public Policy Center's Survey of Direct-to-Consumer Testing Statutes and Regulations for a list of regulations by state.

In some respects, direct access testing has been around for some time. Over-the-counter home tests are a type of DAT since they do not require a prescription and can be bought and used at the consumer's discretion. Now, the trend has expanded to include laboratories offering clinical tests at the patient's request. In some retail centers, people can walk into a lab and request certain tests; wellness centers offer health screens and other lab tests; and free-standing and mobile testing facilities offer screening tests to the public, such as in grocery stores and pharmacies.

Most DAT labs limit the availability of tests to simple, general health tests such as complete blood counts (CBC), cholesterol levels, throat and urine cultures, diabetes screening (blood glucose tests), chemistry panels, PSA for prostate cancer, thyroid tests, HIV antibody tests, blood typing, pregnancy tests, and urine drug screens. More recently, genetic tests have become increasingly available through direct access as well. 

Pros and Cons

Direct access testing may reduce costs for the patient by eliminating the expense of doctor's office visits, providing vital information to patients who are concerned with a particular health problem or who may otherwise avoid testing due to inconvenience or concerns over anonymity. However, most insurance companies do not cover tests that are not ordered by a physician; therefore, you should expect to pay out-of-pocket for these services.

In addition, labs providing DAT services must provide consumers with reference ranges and some assistance in interpreting the results. However, you are not operating under the guidance of your physician, who may be better able to determine what tests you really need but also what the results of those tests mean in light of your specific clinical signs, symptoms, and medical history.

If you are having genetic tests performed, you may also consider meeting with a genetics counselor, who can help you to better understand these types of tests as well as how to interpret the results. To find out more about genetic counselors and to locate one, see the National Society of Genetic Counselors web site.

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