- Arizona Governor Doug Ducey on Monday signed legislation allowing state residents to get any lab test directly from a licensed lab without a physician's order.
- The bill was supported by Theranos CEO and founder Elizabeth Holmes, who said that the move will help with early detection and prevention. "Every individual has the right to access actual healthcare information when they need it the most, to feel better, do more and live better," Holmes said.
- Tests ordered without a doctor's order don't have to be covered by private insurance or the Arizona Health Care Cost Containment System, and providers are not subject to liability or disciplinary action for failing to either review or act on test results that they did not order.
Interesting timing for this legislation, given the ongoing debate surrounding Mark Cuban's recent Twitter missive stating that those that can afford it should get quarterly bloodwork to establish a "baseline of your own personal health." Industry experts fired back that such testing could produce dangerous outcomes for patients. "More testing leads to more false positives and incidental findings (abnormalities that don't pose a risk to your actual health)," wrote Charles Ornstein in ProPublica. "That leads to a higher probability of treatment. And treatment carries side effects."
There are two separate arguments going on here: Should patients have unfettered access to their own health data, and are regular blood draws to establish a health "baseline" a good idea? The first is ideological, and the second is putting the cart before the horse. If, as Ornstein and others argue, patients who order regular blood tests ultimately do themselves more harm than good, that assumes that the ideological argument has already been resolved: Patients own the right to seek and possess any information about their health that they desire without consultation. (Cuban, for his part, argues that any misdiagnoses and unnecessary treatment would be the purview of physicians, not patients owning their data.)
Ten states (including Arizona until July) allow consumers limited access to testing without a provider's authorization. Twenty-seven states plus D.C. allow consumers to order tests directly, and 13 states prohibit testing entirely without a physician order, according to Theranos.