Theranos and its founders were trapped in the hype and “drink the Kool-Aid” mentality that eventually led to its downfall. Had Elizabeth Holmes had more humility and willingness to scale her grandiose promises of what could be done within a few years, she might have had a small start-up whose innovations could have been part of something different.
One of the great appeals of Theranos was letting patients select and choose their own lab tests, and to have those lab tests be so inexpensive and accessible that everyone can do them, without the cost and intimidation of having to go to a doctor or hospital, and without the need for a phlebotomist to find a vein and suck up entire tubes of blood.
One of the things that Theranos managed to do was to get the Arizona legislature to revise the state rules on lab testing, so that patients can order the tests themselves without the neccessity of a referral from a doctor. This allowed Theranos to put its “Edison” lab testing machines into Walgreens stores in Arizona. Unfortunately, the machines couldn’t perform all the tests on the extensive menu Theranos offered, and customers were understandably upset when they found themselves still getting poked in a vein by an amateur phebotomist or getting inaccurate results.
There are already a few lab tests that only require a prick to the finger to collect enough blood to get a basic result. My husband and I both took non-fasting blood sugar and cholesterol level tests at a quickie clinic several years ago in order to get underwriting for our independent insurance plan. The cholesterol test was high, so the plan we chose wouldn’t cover statins (a medication) for seven years. It’s been almost that long, and I suspect the cholesterol that was high was the “good cholesterol” so we all win.
More recently, I got an (overdue) mammogram thanks to a doctor (who is booked until November.) I wouldn’t know how to get a mammogram without going through a doctor. The hospital she referred me to had to look for her instructions before they would give me an appointment. But because of current laws, I had my results via email before the doctor’s office called to let me know I was just fine.
Likewise, when my doctor orders a series of blood tests for my irregular physical, it feels like I’m making a donation to dracula. The phlebotomist draws out 3 or 4 vials of blood from my veins, and I end up with a bill for hundreds of dollars (which says it could be thousands except for my insurance discount) and a report that says I’m just fine, come back in a few years. Certainly some of those tests could be cheaper, and maybe some of those tests are more important, but I’m not going to pay to have them done all the time.
If some of those tests were cheap and easy to do at home or with a simple machine, I might do them more often, which would take me to the doctor’s office (or an emergency room) more quickly if something was off (at which point, the pros would do their own test, because they love their lab tests.) And if it’s fine and it’s always been fine and I don’t have the symptoms of what it is the blood test is testing for, maybe we can skip it and save time and money on the next physical.)
Self-testing and easy testing is already standard for conditions that require regular monitoring, like diabetes and heart disease. Diabetics can test their blood sugar with finger sticks and kits any time they want, and now some of them have a Bluetooth device they can put on that monitors blood level all the time. If you have heart disease, you probably have your own stethoscope and blood pressure cuff, as well as the use of an app that can alert you if your heart beat becomes irregular. There are certainly other conditions or blood-testable issues that don’t require much.
This may have been Holmes’ original vision, and there are now several start-ups exploring less expensive and less invasive ways of medical testing. If Holmes had been willing to scale down instead of hyping up, she might have been part of (or the founder of) one of such start-ups today rather than being in jail. And we might have more medical tests available for us already.