Primary care physician Fred Pelzman writes that patients are increasingly showing up with lab results from direct-to-consumer testing services, including stand-up laboratories, online portals, and wellness clinics. These tests are often ordered without a clinician's involvement, and patients are told to ask their primary care doctor what the results mean. Pelzman describes receiving a 14-page PDF of labs from one patient, with a note simply saying to discuss the results and next steps with a PCP.
Pelzman says he often doesn't recognize the tests, doesn't know what they're measuring, and wouldn't have ordered them in the first place. The advice attached to these panels, he notes, tends to be generic lifestyle guidance—eat well, sleep, exercise, reduce stress—the same advice he gives before ordering any tests. He also recalls a medical school lesson: don't order a test if you don't know what to do with the result, because if you order enough tests, something will come back abnormal.
The author argues that interpreting these self-ordered panels has become an uncompensated burden on overworked primary care doctors. He suggests that physicians should be paid for the cognitive work of making sense of results ordered by outside entities. While he imagines a future where AI agents help process these results, he emphasizes the need for a better system that gives patients necessary care without resorting to a boatload of tests—especially ones no one really wants the answer to. The piece is a single opinion essay, so no conflicting sources are available{