Will direct-to-consumer diagnostics improve patient autonomy—or just create more work for physicians?

At-home health tests are becoming more popular among patients.

These direct-to-consumer (DTC) tests allow patients to order laboratory panels online (often without a physician’s order) and collect samples at home or visit a retail lab for testing. Results are typically delivered through digital dashboards that may include broad biomarker panels, algorithm-generated interpretations, and health recommendations.

Peer perspectives

Kanwar Kelley, MD, JD, a triple board-certified ENT-otolaryngologist and the co-founder and CEO of Side Health in Orinda, CA, says multi-marker home testing panels can be time-consuming to review, may shift attention toward clinically minor findings, and can create misalignment between physician priorities and patient concerns—ultimately adding frustration and workload.

“Some home testing kits contain several markers to interpret and possibly act upon. Reviewing these markers may take time away from other treatments a patient may need, while the patient's focus may be on an obscure marker that may improve as general health or other chronic conditions improve. There may be a disconnect between the physician's overall plan and the patient's perception of the most important marker, leading to frustration on both sides," he tells MDLinx. "While lab markers are important in patient treatment, reviewing all that this testing provides can be overbearing for physicians."

However, Dr. Kelley also notes an upside: “When patients take the initiative to get their own testing, it does save time, as they will be available before or at the appointment for the initial review,” he says. “This can save time onboarding patients and starting a treatment plan while waiting for lab results. Insurance plans may not cover the markers used in these tests, so ordering a set from a third-party company may cost less and reduce patient and physician frustration."

Impacts on physician workload

MDLinx spoke with three physicians who have seen patients use a variety of at-home tests, including food allergy, microbiome, functional medicine, and cancer screening tests. While appealing to patients, these panels can add clinical and administrative burdens once results reach the exam room (especially for certain specialties), creating follow-up work that might not otherwise exist.

“We welcome follow-up with patients who are concerned [about] or confused by home testing results. We are able to perform many diagnostic tests ourselves, which is helpful not only for continuity of care but [also] also for maintaining a strong relationship with our patients. At-home testing doesn’t make a significant improvement in workload for family physicians; in fact, in some cases, it is likely to generate more work and cost to follow up on false positives or clinically insignificant results,” Elisabeth Fowlie Mock, MD, a family physician and a director of the American Academy of Family Physicians’ board of directors, tells MDLinx.

Risks for patients interpreting results

Dr. Mock says the tests can also make things difficult for patients, leaving them without guidance.

“When patients are left by themselves to interpret test results or other health information without the added support of a physician, regular labs can get overwhelming, and manageable diagnoses become devastating," Dr. Mock says. "Minimally abnormal results, which are not a concern to the physician who treats a patient longitudinally, might be stressful to a patient reading a canned interpretation.”

Dr. Kelley agrees: “There may be a disconnect between the physician's overall plan and the patient's perception of the most important marker, leading to frustration on both sides.”

The bottom line: As DTC testing becomes more common, physicians may increasingly find themselves recalibrating expectations: helping patients distinguish between clinically meaningful findings and benign variations. Without that guidance, expanded access to data can just as easily heighten anxiety as improve care.