Understanding the New Dynamics of Respiratory Test Ordering: What Diagnostics Teams Need to Know

Respiratory testing sits at the heart of the diagnostics industry. For decades, influenza, strep, RSV, and other common respiratory infections followed regular seasonal rhythms. Ordering patterns were reasonably consistent across regions, and diagnostic companies could rely on historical trends to plan product launches, staffing, and forecasting.

Today, the landscape hasn’t become chaotic—it has become more nuanced. Ordering behavior varies more meaningfully by region, practice type, patient population, reimbursement conditions, and in-office capabilities. COVID-19 played a role in accelerating some of these shifts, but the deeper changes are structural rather than temporary.

As upstream marketing, strategy teams, and commercial leaders reassess their assumptions about the respiratory market, one conclusion is becoming clear: understanding physician-level ordering patterns is now essential for accurate forecasting and effective go-to-market planning.

This article explores how respiratory test ordering has evolved, why those changes matter, and what diagnostics companies can do to better understand the new dynamics shaping the market.

Respiratory Testing Has Always Reflected Clinician Behavior

Although diagnostic platforms often market themselves on accuracy, speed, or technological advantage, real-world ordering decisions are shaped primarily by practice workflows and provider preferences. These influences include:

• how a clinic structures patient visits

• whether staff are comfortable performing in-office testing

• turnaround time expectations

• practice culture and historical habits

• ordering friction such as payer rules or prior authorization

• whether patients expect immediate results

When these factors shift—even subtly—ordering behavior shifts with them.

For example, urgent care clinics with high patient throughput often favor rapid antigen tests during peak respiratory season. Conversely, some family medicine practices may consistently select PCR for influenza or RSV when laboratory turnaround times are reliable. Pediatric groups may vary between antigen and molecular based on staffing and seasonality.

These differences highlight an important truth: ordering patterns offer one of the clearest windows into how respiratory testing is actually used, far beyond what guidelines or product sheets suggest.

Seasonality Is Still Real—But Less Uniform Across Regions and Specialties

Historically, respiratory seasonality followed a predictable national curve. Today, those curves still exist, but they no longer align cleanly across regions.

This variability doesn’t make the market unpredictable. It simply requires diagnostics companies to move away from relying on national averages. Teams who map local patterns—instead of assuming uniform national behavior—forecast more accurately and communicate more effectively.

In-Office Testing Has Become a Structural Component of the Market

One of the most significant long-term changes in respiratory diagnostics is the growth of in-office testing. The spread of CLIA-waived antigen devices and compact rapid molecular platforms has reshaped how practices diagnose respiratory infections.

In-office testing doesn’t just replace send-out testing—it changes behavior:

• Practices may test more frequently

• They may alternate between antigen and molecular depending on volume

• They emphasize speed during peak weeks

• They emphasize accuracy during slower periods

The relevant question is not simply:

Does a practice own an in-office instrument?

But rather:

How does that platform influence day-to-day ordering behavior?

This is why physician-level utilization data has become indispensable.

Every US physician at your fingertips. Always.

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Respiratory Volume Is Concentrated Among a Small Subset of Providers

Respiratory testing volume is not evenly distributed. A relatively small number of practices—large pediatrics groups, urgent care chains, multi-physician family medicine clinics—drive the majority of testing.

Supporting evidence on provider concentration:

• JAMA analysis on distribution of outpatient visits

  👉 https://jamanetwork.com/journals/jama/fullarticle/2789384

For commercial teams, this concentration influences:

• territory design

• segmentation

• forecasting

• product messaging

Understanding where real volume exists prevents wasted effort and ensures commercial resources align with actual demand.

COVID as Context—Not the Defining Narrative

COVID-19 reshaped aspects of respiratory testing, but its lasting impact is behavioral, not volume-based.

Helpful references:

• CDC COVID testing trends archive

  👉 https://covid.cdc.gov/covid-data-tracker/

• NIH research on COVID-era testing shifts

  👉 https://www.nih.gov/news-events

COVID showed how quickly ordering can adapt when workflows, incentives, and patient expectations shift. Today, with respiratory volumes mostly normalized, the structural patterns (in-office testing, local seasonality, patient mix) matter more than COVID-specific anomalies.

Why Physician-Level Ordering Visibility Has Become Essential

Modern respiratory go-to-market strategy depends on answering:

• Who is ordering which tests?

• How does ordering vary by practice type?

• How do in-office instruments change behavior?

• Who are the stable high-volume testers?

• How do payer rules influence ordering?

• How does seasonality differ locally?

Looking Ahead

Respiratory testing will remain a high-volume diagnostic category, but the drivers of that volume will continue to evolve.

Diagnostics companies that invest in:

• physician-level data

• seasonal mapping

• high-volume practice segmentation

• understanding in-office vs send-out dynamics

…will have a sharply differentiated competitive advantage.

Those relying on outdated national averages will increasingly struggle to anticipate demand or influence adoption.

Ultimately, the future of respiratory diagnostics depends not on predicting pathogens, but on understanding providers.

Further Reading:

1. How to Win in MedTech: 5 Data Strategies Driving Commercial Success

2. The Limits of CRM in MedTech and How Data Intelligence Fills the Gaps

3. Turn HCP Segmentation Insights into Smarter MedTech Engagement Strategies

FAQ

Why are respiratory test ordering patterns more variable today?

Local workflows, staffing, patient mix, and in-office devices now drive variation far more than national seasonality averages.

How has in-office testing changed ordering behavior?

CLIA-waived and rapid molecular instruments have increased testing frequency and shifted decisions between antigen and PCR based on workflow needs.

Is respiratory seasonality still predictable?

Yes—but timing differs significantly by region and specialty, as seen in CDC and HHS respiratory trend data.

Why do diagnostics companies need physician-level data?

It identifies high-volume testers, practice-specific behavior, local variability, and real utilization patterns.

How should commercial teams adjust their strategy?

Focus on provider clusters with real volume, tailor messaging to behavior, and design territories around true demand.