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Manage Your Labs and Diagnostics

Lab tests can give you important clues about your overall health and the state of your chronic health condition(s).

Many of these tests should be done shortly after learning you are diagnosed. These initial tests will establish a baseline measure of your immune health and provide an indication of how active your disease is. Follow-up tests will help you to keep an eye out for changes in your health over time and monitor the impact of your individual treatment regimen. As such, it is important to stay on top of your labs and diagnostics using a calendar or another system that works for you. Here are some tips for making the most out of these tests.

Prior to undergoing any tests…

  • Make sure you understand:

WHAT tests are being performed

WHY they are being performed

HOW they will be performed

WHEN you should expect to receive results and how you will receive them

ASK questions if you need more information

After tests are performed…

  • Set a reminder to follow-up with your health care provider, if results are not received in a reasonable amount of time. Remember, your lab results may be the first thing on your mind, but a lower priority for a busy health care provider. Advocate for yourself by ensuring that you receive and understand all lab and diagnostic results. In some cases, this may be best achieved by scheduling an appointment with your provider to review your results in person.
  • Your health care provider should always be your main point of contact for interpreting test results, but sometimes it may be helpful to refer to other, readily accessible sources of information as well. Several reputable websites exist to help individuals understand why specific tests are performed and interpret lab results. See Understanding your results below.
  • It is your right to obtain and keep copies of all your lab reports (you may have to request these from your health care practitioner’s office, the lab that performed the testing, or your health care system’s online patient portal). It is in your own best interest to obtain and review copies of all lab reports, even if your provider’s office contacts you to say that your test results were normal.

Read on to learn more about how to understand your lab results, tips for requesting lab or diagnostic orders from your doctors, and information on Direct Access Testing, which in some statees allows patients to order their own tests without a doctor’s order.

Understanding Your Results

“In general, laboratory test results must be interpreted in the context of the overall health of the patient and are considered along with the results of other examinations, tests, and procedures. A doctor who is familiar with a patient’s medical history and current situation is the best person to explain test results and what they mean.” – National Cancer Institute

Understanding your lab reports can be difficult at first. The results may appear to be reported in a foreign language that could take some time to comprehend fully. In addition, many factors beyond your disease state can affect the results that you will see on your lab reports.  Gender, age, stress levels, medications, and many other outside influences can have a significant impact on your lab reports. You should always keep in mind that many factors can influence your overall health, so changes in your lab reports may not be a direct result of a specific change in your treatment. Your health care provider should always be your main point of contact for understanding and interpreting your lab results. In addition, there are web-based tools and apps that allow you to further explore your tests and lab results. These tools may allow you to “dig deeper” on your own schedule and do not present the time constraints you may encounter with a scheduled doctor’s appointment. These tools should be used to supplement – not replace – consultation with your healthcare provider and may also be helpful in organizing thoughts and questions you have for your provider about your lab results.

Lab Tests Online, American Association for Clinical Chemistry:
Lab Tests Online is an award-winning health information web resource designed to help patients and caregivers understand the many lab tests that are a vital part of medical care.

Quest Diagnostics:
Helpful tips for patients on what to do and things to consider before, during, and after laboratory tests are performed.

Laboratory Corporation of America:
Helpful information on what tests are needed, available apps, and ordering tests from Lab Corp for patients and physicians.

Lab App for Apple:
Medical Lab Tests is the perfect pocket tool for medical laboratory tests and enables you to browse through a huge library of common lab tests to find out more about clinical laboratory values.

Requesting Tests

In the patient-doctor relationship, it’s usually the doctor who recommends and orders the specific labs and tests best suited to diagnose, track, and assess your medical condition(s) and overall health. But once in a while, there may be a test you want to receive that your doctor hasn’t yet discussed with you or that she is hesitant to order. In this situation, self-advocacy and clear communication are important.

Here are a few self-advocacy and communication tips you can use:

  • Clearly explain to your doctor what test you want performed and why. Provide information to support your request. For example, a recent scientific article or evidence of a genetic connection, such as heightened risk of developing a disease due to a family member with a diagnosis.
  • Get a second opinion. It’s always your right to request a second opinion, and most doctors will support you in this action. Learn more.
  • Visit a doctor specializing in integrative medicine, functional medicine, or complementary medicine. These doctors may perform a wider array of tests to get at the underlying cause of a disease. Caution: insurance may not reimburse for tests deemed to be ‘medically unnecessary’.

And a few things to keep in mind:

When it comes to diagnostics, doctors are best. Testing and diagnostics is one area where western medical excels, and in which medical doctors are well trained. If you aren’t satisfied with your doctor’s diagnostic approach, try to start a discussion to understand more, before assuming you know which tests are best for you. The best way to be an effective self-advocate is to be an effective communicator.

Insurance may not cover all tests. There are several reasons an insurer may deny a claim for testing and diagnostics. You are more likely to pay out of pocket if your tests were not ordered by a medical doctor. If having any tests performed that were ordered by a complementary health care practitioner, or which you are ordering yourself, get the costs upfront.

Over testing is a problem. ‘Low-value’ care – tests or treatments that provide no value to patients and may even be harmful – is a real problem in the United States (see references below), costing billions of dollars and negatively impacting patients’ wallets, health and quality of lives. A doctor who declines to order a particular test may be doing so to protect the patient, not out of negligence.

References

Direct Access Testing

Sometimes, a doctor may decide not to order a test you want, even after you’ve clearly communicated your reasons for requesting it. In many states, lab tests can only be performed with a doctor’s order. However, increasingly, individual states are allowing patients to directly order their own labs (also called ‘direct access testing’). While this may seem an appealing option, especially if you and your doctor don’t agree on which tests should be performed, there are several things to keep in mind before ordering your own labs.

  • Not all tests can be self-ordered: The labs available for direct access testing vary by state; it’s possible that the tests most relevant for your healthcare management needs are not available by direct access testing.
  • Insurance won’t pay: You will most likely have to pay out of pocket for all direct access testing labs. Make sure you understand the costs upfront.
  • False positives and negatives: Depending on the test ordered, your chances of receiving a false positive or false negative range from extremely low to very high. This means that a test could incorrectly indicate an abnormal, or positive, result when in fact everything is normal. Inversely, a false negative occurs when a lab test comes back normal, or negative, when in fact, it should have been abnormal, or positive. These readings could lead to unnecessary stress and worry or an inaccurate assumption that everything is fine. A doctor or licensed healthcare practitioner has the training to interpret test results and maintains awareness of tests more likely to result in false positives/negatives. He or she will re-order tests when appropriate, to ensure accurate results.
  • Support and linkage to care: Receiving an abnormal or positive test result is scary, and you are likely to have many follow-up questions. Receiving results through trusted medical providers helps to ensure proper support and linkage to care after a difficult diagnosis.

If you’re interested in ordering your own tests, it’s best to speak with a trusted healthcare provider first. Read more on self-advocacy tips above in “Requesting Tests” that you can use when communicating with your doctor.

The Integrative Model of Health