I'd love to get a simple blood test without needing to talk to my doctor (plenty of people would). I would not love to get a blood test misrepresenting its accuracy (nobody would).
Lab tests have significant margins of error. Just by chance, if you go out and get a bunch of lab tests, you'll probably find something "wrong". Unless you're knowledgable about interpreting the results -- and unless you are a practicing medical doctor, you are highly unlikely to be knowledgable, even if you think you are -- this can/does lead to catastrophically bad outcomes.
(And now, for an ironic aside: the median HN user is extremely quick to attack valid science for the reason that "most results are wrong", while also complaining loudly when the medical establishment wants to restrict access to clinical tests with a large margin of error. Go figure.)
Moreover, the interpretation of an STD test is not as straightforward as you might think. False positive rates can be high for the cheaper tests, and there's natural variability in things like antibody titers. People also neglect that timing matters -- if you test too soon after infection, even the most sensitive tests won't work. Or they fixate on one particular scary illness (e.g. HIV), and neglect testing for others that are less well-known, but more common (e.g. Chlamydia). Some of these problems can be mitigated. Others can't.
Regardless, having someone trained to interpret tests is a good idea for just about everyone. Even the cheap/free/OTC tests come with that service, at a minimum. It's a bad idea to just allow people to pick and interpret their own tests, even for the "simple" ones, like STD tests.
Car analogy: is there any point in taking your car to a garage and having them look it over and just make a list of the status of common components on the car, without any (vehicle specific) interpretations? As in "you have 5/16 inch wear difference between the front left and right brake rotors, the steering toe-in is 1.3 degrees, and the alternator is providing 13.2 volts".
If not, why is the blood test thing different?
Blood tests are flagged as abnormal if they exceed the 95% confidence interval. So there is a possibility of it happening by chance. Or you may get some abnormality due to minor issues like a recent cold or injury. But then you just need to start a conversation with your doctor to get clarity.
Did you know your kidney health could be down to 10-20% of capacity and you would not even feel a thing wrong? And something happened to me in 2 intervening years of tests for that exact scenario to happen. I doubt most people have tested anything other than their cholesterol and BP in the last two years. If anything, we should be checking our body health more than our car because we can always replace our car.
You can pay to get blood work done even without a doctor in most cases but there is actually very little use for it if all you going to get is some standardized report without any good way of actually analyzing and no i don't thin theranos had a good system in place to bring that to the masses and this isn't something that needs to be brought to the masses in the first place.
Instead of finding a way to allow you to get your blood tested in the same manner as you would develop film 15 years ago why not work on making doctors more accessible?
Doctors and trains hemotologists is what you need scalability was never an issue.
> Because once the patient has those test results, more likely than not, they're going to need a doctor's opinion to decipher them and to know what those results mean. So why not keep the doctor involved from the beginning so that, first of all, there is a logic for getting the blood test, and then there's an expert opinion there when the test results arrive to help you interpret them.
I call BS on that. Many, if not most, tests would NOT need any doctor involved if the test came back normal, which in the majority of cases, it does. Heck, when I go to my doctor NOW and have to get a test, if everything is normal I just get a phone call: "Yep, everything was normal." Explain again why a doctor needs to be involved in that process?
As another example, look at STD tests. Anyone can walk into one of thousands of clinics around the country to get a suite of STD tests, no doctor required, and only if a test comes back positive would you need to see a doctor. So why is this so different from other types of tests?
Understanding the results of multiple medical blood tests requires some knowledge of multiple subjects including biochemistry, chemical pathology, microbiology and immunology.
There's also the question of what to do next - do you repeat the test, get additional blood tests, get other tests (such as radiology or biopsies) and most critically do you actually have a diagnosis and do you need treatment? (If so, what?)
Then there's the issue of false positives and false negatives which most people get wrong (especially if you're in a low prevalence population).
The doctor needs to be involved because there's no guarantee that things will be normal.
Also depending on the test you may or may not understand what "normal" means.
Here's a quick test - These are some of the most commonly ordered blood tests: Which of these tests would you be happy to interpret yourself?:
- CBC (Including HB, platelets, differential blood count, neutrophils, leucocytes)
- Urea and electrolytes (Sodium, potassium, urea, creatinine, U/Cr ratio, chloride, bicarbonate, Anion gap)
- Liver function tests (ALP, AST, ALT, CBr, UBr) If abnormal - Hepatitis serology (including HBsAg, anti-HBc, IgM anti-HBc, anti-HBs)
- CMP (Free calcium, bound calcium, protein, magnesium, phosphate)