The other day, I was taken aback by a question from a new patient. She asked me, “Dr. Chan, are you able to order… lab tests?” The tone in her voice was almost as if she was taking a stab in the dark and expecting her query to go nowhere. In my mind, I was thinking, “Can I order lab tests? OF COURSE!!! Pick a test, any test!”
Sometimes, as naturopathic doctors, we get caught up in our own little world and forget that the majority of people have little idea about what we can do or the kinds of conditions we can treat. As a naturopathic doctor practicing in the lower mainland, I can write a lab requisition and send my patient to any LifeLabs or BC Biomedical collection site to have testing done, just like a patient would if they were being sent by their family doctor. The big difference is that MSP covers the labs requested by the MD whereas the patient pays out-of-pocket for the tests that I request. The question is, then, why would anyone bother going to a naturopathic doctor for testing?
There are several reasons for this. Besides the fact that many people choose to have a naturopathic doctor as their sole primary care provider (perhaps because they cannot find a family medical doctor who is able to take them on as a patient), naturopathic doctors are not as restricted in the types of tests that they are able to order. This is because when the patient pays out-of-pocket, they have the power to choose from the full array of testing available. On the other hand, when public funds are being used to cover the testing, the testing options are much more restricted.
Take for example the patient who asked me about whether I was able to order lab testing in the first place. She said, “I want to get my thyroid checked.” After inquiring a bit more about her health history, she explained about her symptoms relating to fatigue, weight gain, and poor mood but every blood test that she had done showed that all her results were “normal”. The problem here is that the typical screening blood test only includes thyroid stimulating hormone (TSH) and if the results show levels within the normal range then that is as far as the testing path will go. Yet, a full thyroid panel will also show levels of inactive and active thyroid hormones that can give more useful information to help understand what the dysfunction is.
Furthermore, there is a plethora of advanced laboratory testing for things such as hormones, allergies, parasites, heavy metals, nutrient status, genetic defects, and more. Much of this testing is better able to identify DYSFUNCTION versus most standard lab testing which is geared towards identifying DISEASE. Functional testing allows us to provide treatments to help patients achieve optimal health rather than waiting until someone is sick before doing anything.
Like anything, you can have too much of a good thing. Without a strategic approach to assessment and diagnosis, lab testing can get very expensive and it is my job as a naturopathic doctor to provide my opinion to patients about the kinds of tests that will provide the most useful information to help them get better faster. So, ultimately, it’s better to have too much choice than not enough.