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Comment by goodcjw2 | Hacker News Reader

Lab test, or medical practice in general, is a well protected industry here in States. The public wasn't educated well enough to understand lab tests at all so that professional opinion IS REQUIRED to understand your own health.

I might be over cynical here, but I blame that both medical education and health care industry are restricted and protected to cause a very inefficient public health system in US. Thus normal people without a MD has no clue to judge good product vs bad product. In the case of Theranos, I don't think most of understand what's going on with the test. How the test works, how to judge whether it's effective, how to compare pros and cons between different products. We have no idea. I doubt whether the report himself understands the real deal behind the scene, or even investors of Theranos understands it.

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I'm pretty sure it wasn't the "doctors get to be gatekeepers" problem that held back Theranos here. Rather, it was the "they don't have an actual working finger-prick test and have avoided numerous cheap ways to prove they have one" problem.

In contrast, 23andme can legitimately claim to have been held up in that respect. They did have a working product, which correctly identified the patient's genes, and correctly reported the state of the literature on each gene; no one claimed otherwise. It's just that the combination of those two services counts as a medical device under current law, and they didn't get regulatory approval first.

I tend to agree with you on Theranos. I wasn't trying to say that Theranos is doomed from the beginning because they are about to disrupt a well protected industry. Instead, I feel the problem is that we as general public are not educated well enough to make a reasonable judge on whether Theranos is actually working.

If medicine was actually simple enough for a layperson to understand without training, I'd expect to hear more than a few medical students saying, "it's all just a hazing ritual, biology is actually trivial." That is a staggeringly large number of conspirators to have successfully kept a secret.

I order blood tests from my doctor, a couple days later I get the results with two sentences, probably pre selected from the app they use. The doctor adds no value, but creates costs.

You're lucky then. Congrats.

Not so simple for others.

This is extremely simplistic logic. (I'm a physician).

Blood tests vary from very simple to extremely complex, extremely reliable to extremely variable and requiring no further action (as in your case) to requiring multiple possible further decisions.

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).

So yeah, I like to think we still add value.

I worked for a medical lab and a large part of my job was double checking that the doc selected the correct macro.

For some stuff a large amount of interpretation is needed, for a simple PCR test it is not needed 99.99% of the time. The possible interpretations have already been entered and the doc selects one based on the result. It could be automated, but against the law since the doc has to do it. There is that 0.01% chance that something else is going on and the doc will pick up on it when seeing other results/patient history and will end up writing additional interpretation or something very different.

However, that result is rarely seen by a patient. It goes back to the treating physician who then reads it and interprets it himself and uses to guide treatment.

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