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Where Lab Tests Are Performed

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Through a Direct Access Laboratory

Direct access testing (DAT) allows consumers to order their own laboratory tests without consultation with their healthcare practitioner.

As with point-of-care (POC) testing, direct access testing, also called direct-to-consumer (DTC) testing or patient-authorized testing, has been growing in popularity over the past several years. DAT is another a reflection of Americans' focus on health and preventive medicine, offering individuals the opportunity to take more active roles in their healthcare. Most states in the U.S. permit some degree of direct access testing.

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 individual's request, without consultation with their healthcare provider. 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 such as those in grocery stores and pharmacies offer screening tests to the public.

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.

As with POC testing and home testing, direct access testing may benefit individuals by reducing the expense of office visits, providing vital information to individuals who are concerned with a particular health problem or who may otherwise avoid testing due to inconvenience or concerns over privacy. However, most insurance companies do not cover tests that are not ordered by a healthcare practitioner, so 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 healthcare provider, 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 genetic 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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