Although Holmes' company is advancing steadily in its market, not everyone is comfortable with the idea of making blood tests so easy and cheap that patients can get them without going through a doctor.
Holmes believes that the seventy-five-billion-dollar testing marketplace could grow to two hundred billion dollars, as more people take it upon themselves to go to a pharmacy and request blood tests for pregnancy, high cholesterol, and other common medical issues. At the moment, most such blood tests require a doctor’s note; Holmes says that this would have to change, and could. “There are states in the U.S. where citizens can order tests directly,” she said. “The fact that in some states it’s illegal for someone to be able to get basic data about their body—for example, you’re pregnant or you’re not, you have an allergy or you don’t. Not a lot of sophistication has to go into the interpretation of that test.”
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Prescriptionless blood tests raise a host of questions. “Will insurance be willing to pay for patient-ordered blood tests?” Bruce Deitchman, a dermatologist and pathologist, said. Deitchman has served as an alternate member of the American Medical Association’s expert panel that recommends reimbursement rates to Medicare. “Will Theranos insist that test results be sent to physicians, and will patients want their doctors to know?” He noted that doctors are legally obligated to follow up and address abnormal blood tests with patients. In the absence of a doctor, will Theranos be held to that standard?If blood tests become as cheap and easy as Holmes wants, however, the medical establishment will no more be able to block patients' access to them than it can prevent their taking their own temperature and blood pressure.