Technology continually revolutionizes the medical industry, presenting laypeople with increasing options for managing their own health care. Each invention brings hope of earlier diagnoses, easier treatment, and more affordable medicine, much of which patients can access from the comfort of their homes. 

Each innovation also brings a flood of contention, as experts decide what technology “regular” people should be allowed to utilize, and what medical gatekeepers should control. At the forefront of that debate lies Direct Access Testing (DAT), which has exploded in both availability and controversy.

What DAT Is (And Is Not)

Agreeing on definitions is paramount in any debate, particularly when the terminology is vague. The Centers for Medicare & Medicaid Services states DAT is “consumer (as opposed to physician) initiated testing of human specimens… commonly ordered by an individual without a prior consultation with a physician or a physician’s request for testing.” 

Put simply, it is any test a patient requests without getting a referral from a physician. If a patient in a state allowing DAT wants to check her iron level, she need not schedule a doctor’s appointment, sit in the waiting room, get the workup by the nurse, talk to the doctor, and then walk over to the lab with the physician’s order. She can walk directly into the same lab, with the same safety standards and regulations, and request the same test a doctor would have ordered.

The over-the-counter (OTC) pregnancy test a woman buys at the drugstore and does entirely by herself, on the other hand, is not a DAT. Oddly, this type of easily-accessible screening has comparatively little oversight by state or federal governments. Virtually anyone, anywhere, can order a test kit, take it alone, and keep the results to herself. Most DAT, in contrast, is entirely forbidden in many states. 

What reasons do opponents give for their objections?

The Testing Might Be Unnecessary (And Unnecessarily Expensive)

Some practitioners express concern that individuals will request costly tests they don’t need. This is almost certainly true. 

It’s also irrelevant. Patients generally already pay for the tests, passing on minimal or no costs to insurance companies or other insured patients. If legislators are going to restrict purchases based on what they determine consumers need, “frivolous” healthcare tests are an odd place to start in a country that spends $110 billion annually on coffee.

More importantly, doctors are mere mortals who have repeatedly shown they can make dangerous—even deadly—mistakes. Medical errors injure an average of 400,000 patients every year. It is the height of arrogance for a physician to deny a patient a test (at least a harmless and self-funded one) because the doctor is certain she knows best.

Patients Might Seek Inappropriate Treatment 

Again, this is both true and irrelevant. A patient, who receives a disease diagnosis directly from a doctor, does not receive legal orders to follow any prescribed treatment protocol. Patients often disagree with their physicians’ advice, they know it could be flawed, they are under no obligation to follow it, and about half do not even take their medication as prescribed. 

Receiving the diagnosis on a lab paper changes nothing in this scenario. Individuals who trust their doctors will seek and follow their instructions. Individuals already distrustful are unlikely to follow directions blindly after a diagnosis. Building trust will result in proper care far more effectively than denying patients access to their own medical information. 

It Hurts Business

Doctors are unlikely to put it this plainly, but the evidence is all there. When an entrepreneur created an app enabling consumers to check their own vision and order glasses, a throng of optometrists lobbied their legislators to prohibit its use. Mind you, people were not ordering new eyeballs and fitting them at home. These were just… glasses. And all around the country, people try on reading glasses at the grocery store and purchase the pair that seems to help their vision best. As far as can be determined, no deaths have been attributed to this practice. 

The phrase “for your own good” is often an excuse to protect the financial interests of medical professionals. Even when it is used with the best intentions, it is rarely an acceptable reason for one adult to limit the healthcare options of another.

The Result 

How ironic that in 17 states, a woman can demand an abortion without apology, funded by taxpayers, yet she might not be able to demand access to a simple and safe personal test at her own expense. Instead of being the “CEO of their own health,” patients are still under the thumb of those with enough money to shut them out of their own health care.

As R Street Institute’s Steven Greenhut says, “It’s time to rebuke the naysayers, take some responsibility for our own lives, stop worrying about every piddling potential downside of innovative new ideas—and recognize the amazing times we’re living in.”