Self-Ordering of Pathology Tests in Nigeria: Implications for Medical Practice and Patients’ Safety.

Abstract

The global healthcare landscape is witnessing a significant shift towards patient autonomy, exemplified by the growing trend of self-ordering of pathology tests, also known as Direct Access Testing (DAT). This model, which allows individuals to request laboratory investigations without a physician's referral, is emerging in Nigeria amidst a complex healthcare system. This narrative review synthesized existing literature to explore the opportunities and challenges of DAT within the Nigerian context. We examined the drivers, including digital health   advancements, limitations in traditional healthcare access, and growing patient empowerment. Conversely, we critically analysed the profound implications for medical practice, including the potential for misinterpretation of results, overdiagnosis, unnecessary treatment, and the erosion of the clinician-patient relationship. The review also highlights specific systemic challenges in Nigeria, such as variable laboratory quality, the proliferation of quackery, and a weak regulatory framework. We argue that while DAT presents a potential avenue to improve healthcare access, its integration into the Nigerian health system requires robust regulatory oversight, stringent quality management systems in laboratories, extensive public education, and a collaborative model that preserves the essential role of medical guidance to safeguard patient safety.