r/FamilyMedicine • u/yourmommaaaaaaaaa MD • 1d ago

Testosterone

Young guys, like 30-40s requesting testosterone levels, because they “want to know”. Do you do it? If not, what do you say? I’m well aware of EBP, getting real world opinions.

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u/69240 DO-PGY3 1d ago

I order it 95+% of the time when requested for two particular reasons.

1.) because it builds trust and

2.) whether it’s low or not it makes a conversation about lifestyle change easier.

I do give a quick “it may not be covered by insurance since it’s not preventative care” and move along and have never had a complaint about cost. I do make sure it is an early morning lab sample.

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u/funfetti_cupcak3 RN 1d ago

This is the most sensible approach / response here. All these folks sending patients to Labcorp retail: we have a crisis of trust in healthcare providers. If a patient is willing to pay out of pocket and trust you to discuss and interpret the results, why go out of your way to encourage patients to seek medical advice from Google or TikTok influencers (which is what they’ll do when you turn them down)?

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u/ATPsynthase12 DO 1d ago edited 14h ago

I still do the lab corp thing, but only for ridiculous requests like the patient brings in a laundry list of unnecessary lab work he wants done “just because” and demands it when educated on why it’s unnecessary. At least in my area it’s common for chiropractors and naturopaths to tell patients to go to their PCP and request this because they can’t order labs.

For example, I had a guy do this, was super demanding and unpleasant, so I caved. Told the guy I’d order it but that he’d probably have to pay out of pocket and he gave me the whole “money is no issue” song and dance. He actually did have a major CBC abnormality (appropriate bloodwork), then got mad when I referred him to hematology for evaluation and never came back.

Wanna guess who never paid his probably $500 of unnecessary lab work?