Abstract
Changes have occurred in the organization, complexity and role of medical laboratories in healthcare, requiring a great increase in global productivity and diagnostic efficiency by enrolled professionals to withstand new challenges. Such a radical evolution, which should be very attractive for new generations of professionals, is counterbalanced by an increasing shortage of laboratory vocations worldwide, particularly in community hospital and large reference laboratories, which may lead to a serious crisis in the field of laboratory medicine in the very near future. Some reasons can be highlighted, including the decreased interaction between clinicians and laboratory professionals, centralized testing, and the development of innovative, minimally invasive techniques that can easily be handled without direct control or supervision by laboratory staff. The prospect of a professional decline in laboratory medicine can be offset by increased awareness of the radical changes occurring within clinical laboratories and re-professionalization of laboratory scientists. This will require new resources to attract young professionals, and should include reaffirmation of the role of laboratory consultants and active participation in the development, implementation and monitoring of innovative diagnostic systems. The “patient” appears to be in a serious condition; it is in our hands to let him be reborn.
Clin Chem Lab Med 2006;44:913–7.
References
1. Plebani M. Charting the course of medical laboratories in a changing environment. Clin Chim Acta 2002; 319:87–100.10.1016/S0009-8981(02)00028-1Search in Google Scholar
2. United States Department for Health and Human Services. The clinical laboratory workforce: the changing picture of supply, demand, education, and practice. Available at: http://bhpr.hrsa.gov/healthworkforce/reports/clinical/default.htm. Accessed April 6, 2006.Search in Google Scholar
3. Peterson LC. The crisis in America's laboratories: it's every physician's business. Med Gen Med 2005; 7:49.Search in Google Scholar
4. Pagni A, Plebani M. The laboratory and the general practitioner. Clin Chim Acta 1999; 280:13–24.10.1016/S0009-8981(98)00194-6Search in Google Scholar
5. Price CP. Medical and economic outcomes of point-of-care testing. Clin Chem Lab Med 2002; 40:246–51.10.1515/CCLM.2002.040Search in Google Scholar PubMed
6. Matsuo S. Considering what clinical laboratories should become in the future – POCT, mail testing and OTC test. Rinsho Byori 2005; 53:1159–63.Search in Google Scholar
7. Lippi G, Guidi GC, Mattiuzzi C, Plebani M. Preanalytic variability: the dark side of the moon in laboratory testing. Clin Chem Lab Med 2006; 44:358–65.10.1515/CCLM.2006.073Search in Google Scholar PubMed
8. Muller MM, Hackl W, Griesmacher A. Point-of-care-testing – the intensive care laboratory. Anaesthesist 1999; 48:3–8.10.1007/s001010050661Search in Google Scholar PubMed
9. Toner M, Irimia D. Blood-on-a-chip. Annu Rev Biomed Eng 2005; 7:77–103.10.1146/annurev.bioeng.7.011205.135108Search in Google Scholar PubMed PubMed Central
10. Plebani M. Proteomics: the next revolution in laboratory medicine? Clin Chim Acta 2005; 357:113–22.10.1016/j.cccn.2005.03.017Search in Google Scholar PubMed
11. Markin RS, Whalen SA. Laboratory automation: trajectory, technology, and tactics. Clin Chem 2000; 46:764–71.10.1093/clinchem/46.5.764Search in Google Scholar
12. Bachner P. The impact of regulations, accreditation standards, and ‘healthcare reform’ on laboratory practice in the United States. Pure Appl Chem 1996; 68:1847–9.10.1351/pac199668101847Search in Google Scholar
13. Felder RA. Is lab automation right for your lab? CAP Today 2001; 15:42–4.Search in Google Scholar
14. Ricos C, Domenech MV, Perich C. Analytical quality specifications for common reference intervals. Clin Chem Lab Med 2004; 42:858–62.10.1515/CCLM.2004.140Search in Google Scholar PubMed
15. Nordin G, Martensson A, Swolin B, Sandberg S, Christensen NJ, Thorsteinsson V, et al. A multicentre study of reference intervals for haemoglobin, basic blood cell counts and erythrocyte indices in the adult population of the Nordic countries. Scand J Clin Lab Invest 2004; 64:385–98.10.1080/00365510410002797Search in Google Scholar
16. Stroobants AK, Goldschmidt HM, Plebani M. Error budget calculations in laboratory medicine: linking the concepts of biological variation and allowable medical errors. Clin Chim Acta 2003; 333:169–76.10.1016/S0009-8981(03)00181-5Search in Google Scholar
17. Panteghini M, Forest JC. Standardization in laboratory medicine: new challenges. Clin Chim Acta 2005; 355:1–12.10.1016/j.cccn.2004.12.003Search in Google Scholar PubMed
18. Jack A. Organization of neoplastic haemopathology services. A UK perspective. Pathology 2005; 37:479–92.10.1080/00313020500368360Search in Google Scholar PubMed
19. Gurwitz D, Lunshof JE, Altman RB. A call for the creation of personalized medicine databases. Nat Rev Drug Discov 2006; 5:23–6.10.1038/nrd1931Search in Google Scholar PubMed
20. Jain KK. Nanotechnology in clinical laboratory diagnostics. Clin Chim Acta 2005; 358:37–54.10.1016/j.cccn.2005.03.014Search in Google Scholar PubMed
©2006 by Walter de Gruyter Berlin New York
