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Comment by robbiep | Hacker News Reader

As a practicing doctor (albeit a junior one) I simply cannot foresee any more than 1 or two conditions where direct to consumer lab testing would actually be of practical use.

If on the other hand her technology is radically cheaper than the hospitals own lab then it would rapidly achieve huge market share and help cut healthcare costs. Just yesterday I had 2 sets of coags on the same patient sent back necessitating retaking (not an easy job on an elderly severely demented woman), one because it had clotted (apparently) and another because there was not enough blood. Smaller volumes required would be great for a whole bunch of situations.

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I see dozens of conditions this would be good for. I think you get biased once you spend 8-10 years becoming a gatekeeper to healthcare.

People want to take their health into their own hands and not have to have every test blessed by a $150 doctor visit plus a separate lab visit.

Conditions to test for:

Hemachromatosis Many other genetic conditions Vitamin deficiencies (D, B, potassium) Blood sugar for people prone to diabetes Lyme disease (test after every tick bite after waiting the required time period)

And that's just off the top of my head.

Many of those are tests I'd like to a few times a year, but don't want to schedule a doctor appointment, take off work, make a copay, schedule a lab test, take more time off, another copay, etc.

I can't agree with you more. I go hiking a lot and have gotten tick bites. There is nothing worse than having to schedule an appointment and going to the doctor just to have something simple done. Biggest waste of time, vacation/sick days and all to do something that is so easy.

As an extreme but interesting case, I know someone who has had a majority of his endocrine system surgically removed and now relies on self-treatment of hormones. He has had in the past extensive excel sheets tracking his dosages alongside behavior, appetite, energy, etc. It's utterly amazing the amount of correlation he could derive between various hormone levels once he was made directly aware of them.

Similar kinds of information about day-to-day blood chemistry might be available through retail-available blood testing. This is QS all over again, but with a significantly more powerful bite—blood chemistry is a quantitatively powerful look into your body's current state. It's a human debugger.

There are already options for getting tests done without a doctor visit. For example HealthCheckUSA which uses LabCorp to do the testing.

Here is a straightforward use - patient visits the testing center and states their symptoms. Testing center runs the tests. Then the patient shows up in your office, most likely with the labs you'd have ordered already complete. Saves an hour of your (very expensive) time.

If ExpectedValue[Unnecessary Test] < Cost of doctor prescribing tests, this is a win.

That could be the flowchart now where I work if the docs wanted it. It they allowed it, I could walk into the testing center that's already there- and do things exactly as you say.

As it is, for my predictable appointments this is exactly what I do.

She seems to be doing an end-run around the AMA and the states that require a Certificate of Need by installing these devices in drugstores. I think the ultimate goal would be for doctors like yourself to have one in their office.

I think it's more interesting that these are installed in drugstores. Doctor's offices will get them eventually, sure, but there are more drugstores than MDs.

I've had GVHD for 27 years. Long-term followup measures everything they can think of. I'd very much like those tests to be done more frequently.

http://en.wikipedia.org/wiki/Graft-versus-host_disease

Cheaper, better, faster for one of the most common medical procedures? Yeah, I think I can see some value there.

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