Patient-Initiated Laboratory Testing: No Gatekeeper, No Kidding

Abstract

To the Editor.— According to Dr Soloway, 1 open access to laboratory testing is desirable and inevitable. By removing the physician as gatekeeper for laboratory testing, Dr Soloway argues that there would be less need for inconvenient and expensive office visits, particularly for sophisticated patients who desire only a pregnancy test or serum cholesterol test. Patient-initiated testing would create a new and unprecedented channel of information transfer from the laboratory to the patient that would bypass the physician. Test interpretation would become the responsibility of the patient, encouraging self-diagnosis and treatment. This would place inappropriate emphasis on test results, supplanting other important sources of information such as the history and physical examination. Does Dr Soloway consider test interpretation by the knowledgeable and unbiased physician to be of no value? Should laboratory technologists be informing patients that they have serious illnesses such as acute leukemia? Is the laboratory responsible (and liable)