Cheryl Lassiter likes to keep a close eye on her cholesterol levels, but with a high-deductible insurance plan, she doesn't want to pay the fees for repeated checkups by her doctor. So a few times a year, she orders up a lab test herself, using an online service that charges about $40.
"You cut out the middleman," says Ms. Lassiter, 56, a writer who lives in Hampton, N.H.
Most people get lab tests after a doctor recommends them during a visit. Now, a small but growing number of consumers are skipping the time and expense of seeing a physician and are ordering up their own tests, with heart-related assays among the most popular. For some, it's a way to keep track of measures that they want to regularly monitor, such as cholesterol levels or the blood-sugar indicator known as hemoglobin A1C, which is important to people with diabetes. For others, a broad-based panel of tests may provide a quick snapshot of overall health, or a particular test could address worries about the presence of a possible condition such as hepatitis C.
Here are some lab tests that consumers can currently order online without a doctor visit:
• Lipid panel, which includes 'good' and 'bad' cholesterol, as well as triglycerides
• C-reactive protein, which has been linked to heart-attack risk
• Liver function, looking at measures such as the enzyme alanine aminotransferase, or ALT
Doctors caution that consumers need to be careful about testing services. Here are some steps they can take:
• Check into the lab performing the test to ensure it is accredited by a legitimate organization such as the College of American Pathologists
• Be wary of any company that tries to peddle treatments based on lab results.
• Watch out for over-broad claims about a test's meaning, particularly the predictive power of genetic assays.
Consumers wanting to get their own tests have a number of options. Online services contract with national networks of labs to perform a range of assays. The lagging economy, which has left some people without insurance coverage, has also helped fuel the direct-to-consumer testing market, testing companies say. Even many people with coverage are facing bigger deductibles and other out-of-pocket expenses.
Ms. Lassiter and her husband, who bought their own health plan, have a $5,000 annual deductible. Doctor visits tend to cost around $150 or more, so she only goes for a checkup once a year. She uses the online testing service to more frequently keep track of her cholesterol, which she describes as in the high range of normal, and to monitor a thyroid condition. She says she would call her doctor if she got a worrisome test result.
Direct-to-consumer lab tests are a small but growing part of the overall lab industry, according to research firm Washington G-2 Reports, a unit of publisher BNA Inc. In a 2009 report, the company estimated people were spending about $20 million a year for such tests, and the segment was growing at 15% to 20% annually. Spending on self-ordered testing totaled about $100 million a year with the inclusion of the high-profile and controversial category of genetic testing.
Gary Procop, chairman of molecular pathology at the Cleveland Clinic, says consumers should check that the labs performing work for online companies are certified under CLIA, or the federal Clinical Laboratory Improvement Amendments, and accredited by an established entity such as the College of American Pathologists.