The Modern Era of Lab Testing

When considering modern medical lab tests there are three terms to keep in mind:

“Specialty lab testing”

“High-sensitivity testing”

“Direct-to-patient testing”

Let me break this down for you. Ten years ago, most medical lab tests we

re done in the hospital or by two or three major labs across the country. A doctor’s prescription was required. A patient’s only option was to travel to a lab or hospital for the lab collection. And insurance was required in order to have the testing. I call this “turtle medicine.”

Things are changing fast thanks to collaborations between scientists and entrepreneurs. There are now multiple independent specialty labs available to help clinicians and patients determine the source of specific diseases and – to great applause – prevent future disease. Troponin-I specialty lab testing (Singulex Lab) is a powerful example.

Avoid a heart attack. If chest pain put you in the hospital, the ER doctor would order an ECG and the cardiac enzyme Troponin-I to screen for a heart attack. Wouldn’t it be great if the same cardiac enzyme Troponin I were available as a screening lab for the earliest sign of heart strain (before chest pain and heart attack develop?) It’s here. Micro levels of Troponin-I can now be checked through a specialty blood lab (Singulex) outside of the hospital. If micro Troponin-I is elevated the message is clear - major changes are needed immediately… or else.

Did you know that some people are designed to thrive on a higher carbohydrate diet?

Arguably the most exciting specialty lab test to enter the medical market is genomic testing. I now routinely collect and analyze my patients’ saliva in order to understand what exercise, medications and diet are favored by one’s genetics.

Whenever you see “specialty lab testing” assume there will be some out of pocket expense, but these new focused studies are generally worth the expense.

Modern testing is more accurate. Whenever you see “hs” or “high sensitivity” you are getting tests that have lower error rates. Traditional testing (complete blood count, diabetic lap panels, CRP) have error rates as high as 15%. High-sensitivity testing carries a 5% error rate or less. High sensitivity testing allows more accurate disease assessment, which yields more appropriate treatment plans and more accurate treatment monitoring.

The direct-to-patient testing movement is helping patients be more of their own best doctor. Life Extension, Any Lab Test Now, Direct Labs and others allow patients to create their own account; order their own labs; book a lab collection appointment and view their own results – without a physician’s involvement. Keep in mind that direct-to-patient labs generally have a discounted cash rate, and very few work with insurance if you lack a physician’s orde

Modern lab testing makes it easier to monitor progress with re-testing. You no longer need to wait six months to see if you are on the right medication or lifestyle program. Get re-tested; tailor treatment, then re-test to confirm your progress. And, If you’re like most of my clients and prefer to have a mobile phlebotomist come to your home or office, we can now arrange that for most specialty labs at an added cost of approximately $50.

Reminder: be careful about “test giddiness.” Understand why you are having each test.

In the words of Dr. Russ Jaffe, “testing is not treatment.” You should enjoy learning about your amazing body in ways never before possible. But make sure you have a plan and understand how each test fits into your plan.

The new era of medicine is all about patient empowerment. And modern specialty lab testing that has high-sensitivity and is available in a direct-to-patient model is a powerful tool on your quest to reach your peak. Let’s go!

Adam C. Miller, DDS, MD

Founder, ARISE MD