Aches & Claims: Ordering Up Your Own Medical Tests By Robert J. Davis

CURIOUS ABOUT your cholesterol but too busy to go to the doctor? A growing number of people are using direct-to-consumer lab services, which let you order your own blood and urine tests for everything from allergies to the AIDS virus. The process is quick and easy, but interpreting the results can be tricky without a doctor's help.

Several companies, including Quest Diagnostics Inc., HealthcheckUSA and Direct Laboratory Services Inc. offer direct testing. In some cities, you walk right into a testing facility and place your order. Usually, though, consumers log onto a Web site and choose from a menu of tests for disorders such as diabetes, Lyme disease, hepatitis and prostate cancer. You also can find out about kidney or liver function, check levels of calcium and other minerals and even screen for recreational drugs.

Combinations of tests are offered, too, with names like "women's health profile" and "comprehensive wellness profile." Customers are then directed to a lab in their area where the test is done. Results are sent via mail or e-mail, often within 48 hours. The price typically ranges from $20 to $150, though certain combinations can push it past $500. Insurance doesn't cover the bill. Because the results aren't sent to a doctor, they're not part of your medical record -- an advantage for those who want to protect their privacy.

Many states don't allow people to get medical tests without a doctor's referral. But testing providers often get around the law by having physicians on staff who approve all test requests, no questions asked. With each result, customers are given the range of normal readings, and if a result is way out of line, they may receive a letter urging them to see a doctor. Beyond that, testing services generally don't offer medical advice. That's why it is a good idea to share the results with your doctor, especially if they are out of range. A reading that seems ominous could be a fluke or perfectly normal for you. And keep in mind that certain tests, including those for prostate cancer (PSA) and ovarian cancer (CA-125), are particularly prone to producing false alarms. At the same time, don't assume you are OK if the results are normal, especially if you have symptoms. Direct lab services are best used to monitor the effectiveness of a treatment (like thyroid medication), not for making a diagnosis.
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