09/12/2025
STI Testing and the Role of Physicians: Why It Matters
Generally speaking, any STI testing requested by a patient in the United States requires the involvement of a licensed medical provider. That’s not optional — it’s built into the regulations.
Many states allow what’s called standing orders. In this model, a physician permits their NPI number to be affixed to lab orders and is technically “responsible” for those patients, but there’s rarely a real doctor–patient relationship. Even then, standing orders still require the collection of actual medical information from the patient.
Other states don’t allow standing orders at all, and instead require a much more tangible provider–patient relationship before testing can be ordered.
This is why every legitimate STI testing company includes a medical intake form as part of the ordering process. Even companies like STDcheck.com require you to enter medical information after you’ve paid. And it’s also why “at-home” kits sold by CVS or other retailers aren’t available everywhere — you simply can’t sell a test off the shelf in states where stricter medical requirements apply.
Here’s how we handle it at Shameless Care:
• We do not use standing orders.
• We have a team of 24 board-certified physicians.
• When you order a test, you’re assigned a physician licensed in your state. If two partners order tests together, they’ll usually end up with two separate doctors, assigned by the algorithm.
• That physician reviews your medical history, orders your test, interprets your results, and provides treatment if needed.
Finally, it’s worth mentioning that these rules change. For example, the definition of what counts as a valid doctor–patient relationship (asynchronous vs. synchronous visits) varies by state and has shifted frequently.
During COVID, many states allowed asynchronous visits (no video or phone call, just a form). Some have since rolled that back. On any given month, rules may change in several states.
The bottom line: The regulations around STI testing are complex and constantly evolving. But one thing is clear — you cannot legally cut physicians out of this process in all states.
