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Henry B. Soloway, MD
Las Vegas, Nev

JAMA. 1991;265(4):457-458.

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In Reply.—

Dr Wolfe correctly argues that laboratory data constitute only a part of the diagnostic process and that such data must be integrated with other information to arrive at a diagnosis. But what patient-initiated laboratory testing is really about is (1) who should control information flow, (2) whether it is in the public interest to maintain monopolies on medical or other types of knowledge, and (3) whether consumers with disposable income and a desire for information—eg, pregnancy tests, cholesterol level, stool occult blood—should be denied that information because they are not smart enough to be trusted with test results.

Bostwick et al are concerned about several interesting but irrelevant issues. The potential for abuse in patientinitiated testing is real, but not an issue. There is potential for abuse with many types of medical diagnostic and therapeutic procedures, eg, computed tomographic scans and hysterectomies. Few would argue that these procedures . . . [Full Text PDF of this Article]

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