The Doctor is Out, LabCorp to Let Consumers Order Their own Tests.

Consumers will soon be able to bypass their doctors by going online to order cholesterol readings, thyroid tests and other bloodwork from the biggest diagnostics company in the U.S.
Laboratory Corp. of America Holdings will let customers go online to pay for tests, visit a service center to get blood drawn, then view the results on the Web. The company has already been doing back-office lab work for a number of Internet firms that let people order up tests without a doctor.
Rapid and at-home diagnostics are a growing corner of the health-care market, with businesses like WellnessFX Inc. and Direct Laboratory Services LLC tapping into demand from patients who want to get sensitive results in private or seek to monitor their health outside of the traditional doctor’s office. Companies like LabCorp are tapping into demand from consumers who want to measure their bodies to monitor the effects of exercise and healthy living and to learn about their potential risks of disease.
“We need to retake that territory for ourselves,” LabCorp Chief Executive Officer David King said in a telephone interview. “It’s a growth opportunity for us. It’s something consumers increasingly want to have access to, and it’s something we’re doing already and our capabilities are being utilized without us getting the benefit from a branding perspective.”
LabCorp is also facing competition as options emerge for consumers to get tests without visiting a service center at all. Startup Theranos Inc., founded in 2003, has developed a diagnostic kit available in some Walgreens locations that it says can provide a range of results, from lipid panels to the presence of HIV, with mere drops of blood.
Drugstore Partnership?
LabCorp’s direct-to-consumer business will initially be run online. The company is exploring a partnership with a drugstore chain as well -- an idea that rival Quest Diagnostics Inc. tried and scrapped. The company didn’t say precisely which tests it will offer or how much it will charge. In some states, the law will still require consumers to get a doctor to order tests.
The consumer appetite for health information is growing as devices like the FitBit and the Apple Watch offer more sophisticated ways to monitor the body, and as companies like 23andme Inc. clash with regulators over the interpretations they provide for genetic information.
“We have entered an era where there’s a lot more patient involvement in their health care,” said Steven Lamm, medical director of the Tisch Center for Men’s Health at New York University’s Langone Medical Center. “The concern is when you want to take control of your health without being properly informed about what you’re actually testing.”
Taking Back
Erena DiGonis, a licensed clinical social worker and health coach with a consulting business in New York City and Long Island, decided to order her own bloodwork online when the specialists she saw wouldn’t run certain tests that she wanted done for a thyroid condition.
“It makes you feel like you’re taking back your own health by knowing where things stand,” she said of the testing she ordered online via DirectLabs. “It really empowered me and empowered my clients that I recommended this service to. If you wanted to get your cholesterol tested an extra time each year to see if your diet is working, it’s nice to see concrete results.”
Many of the tests don’t come cheap. WellnessFX, based in San Francisco, charges $988 for its most comprehensive package, which includes biomarkers for omega-3 fatty acids and fibrinogen, a protein produced by the liver. Customers can go to a Quest Diagnostics center to do their bloodwork, and they can add a 40-minute consultation with a physician to discuss the results.
New Revenue
DirectLabs, based in Mandeville, Louisiana, offers more routine tests like a $29 metabolic panel -- glucose, kidney, fluids, electrolytes, calcium and liver -- and a $49 measure of Prostate Specific Antigen, which the company says can be used to detect cancer.
Lab operators like LabCorp and Quest Diagnostics are looking for new sources of revenue as they contend with lower reimbursement from insurers and Medicare. The recent movement by hospital companies to buy up physician-owned medical practices has also siphoned off some of the lab work that the major providers had traditionally done.
LabCorp shares have gained 23 percent in the past year, lifted by a November agreement to buy drug-research firm Covance Inc. for $6.1 billion to expand beyond testing. The stock rose less than 1 percent to $125.35 at the close in New York.
Quest Diagnostics’ 2002 attempt to start a consumer business, offering bloodwork through CVS stores in Florida and Ohio, fizzled by 2006. Quest does offer a handful of blood tests directly to consumers in some states through a program called Blueprint for Wellness Direct Pay.
More Educated
If LabCorp succeeds now, it’s because people are more knowledgeable and interested in their health data than they were then, said William Quirk, an analyst at Piper Jaffray Cos.
“There’s no question that consumers are more educated now than they were five, 10, 15 years ago -- that’s thanks to the Internet and smartphones and apps and such.” Quirk said.
The question is what tests consumers really want, and if they’re motivated to seek data without prompting from a doctor, Quirk said.
“This isn’t like what color iPhone do you want,” he said. “There’s a reason you get a prescription for lab work done, because a physician is seeking information to make a diagnosis.”
Running a consumer business will mean LabCorp must navigate the variety of state laws and regulations on online diagnostics -- some favorable, some challenging. Arizona, for example, passed a law this month that will allow residents to get blood tests without a doctor’s order. More than 20 states allow patients to order blood work without a prescription, Quirk said.
Controlling Health
“The underlying principle is people have a right to control their health, so they should be able to find out anything they want about their health,” King said of the movement in Arizona allowing patients to order any test they would like. The reality, he warned, is far more complicated than that.
“When you get into more complex things like thyroid disease, oncology and infectious disease, I’m completely supportive of the idea that a patient should understand and take accountability for their care -- but there’s interpretation,” he said. LabCorp will make sure protections are in place for some sensitive tests so doctors are involved in explaining what the results mean, he said.
“We want to be sure we’re doing this in a compliant and responsible way.”

Full article quoted from http://www.bloomberg.com/news/artic...order-own-tests.