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FAQs

What is the benefit to the public? What problems will this doctorate solve?

The public will benefit through improved efficiency and quality of laboratory testing and increased patient safety. Costs associated with inefficient and inappropriate laboratory testing are enormous. Tests that are ordered but not useful or necessary waste health care dollars. Tests that are not ordered but should be delay diagnosis and treatment.

A professional with a clinical doctorate in CLS will have the knowledge and stature to develop, implement and oversee protocols for the appropriate ordering of laboratory tests and the use of laboratory information. Physicians have published the need for experts in the use of laboratory information to support patient diagnosis and treatment. Rapidly evolving technology is constantly producing new procedures for testing old and new analytes. It is impossible for physicians to keep abreast of them. A person with a clinical doctorate will be able to apply the newest tests and technologies to patient diagnosis and treatment and teach other health care practitioners how to use them appropriately. This individual will serve to increase the visibility of pathologists.

What is the relationship between the baccalaureate degree and the Clinical Doctorate? What distinguishes the Clinical Doctorate from the PhD?

The BS entry level degree will continue to be offered using a mixture of didactic and laboratory components. Individuals with the BS degree will continue to staff clinical laboratories performing complex procedures and providing technical knowledge. The clinical doctorate will expand the cognitive knowledge base gained at the BS level to enable the graduate to function as a practitioner. Additional skills include patient assessment, management of laboratory data, patient/family counseling skills, and participation in policy setting bodies (i.e. IRB, DSMB, ethics committees) to name a few.

The individuals with the clinical doctorate will focus on expanded knowledge and the use of laboratory data to enhance patient care and contain costs. They will use research findings to advance clinical practices. A doctor of philosophy degree will provide an individual with the same skills as the clinical doctorate, but go further by preparing the graduate to lead and conduct rigorous research that is competitive with PhD's in other disciplines. The graduate of the PhD program would be expected to serve as faculty, conduct research, and publish in peer reviewed journals.

Must the need to gain new skills and capacities be translated into a doctoral degree?

The clinical laboratory scientist currently lacks a credential to be recognized as an individual who can synthesize the vast amount of laboratory data into a product useful for clinicians, patients and the community. The current CLS baccalaureate degree is jam-packed with a body of knowledge that continues to expand, but that graduate focuses on operations primarily within the laboratory. We cannot expect the BS degree programs to cram more and more knowledge and skills into the curriculum without risking serious dilution of the essential core body of knowledge.

The new practitioner must have a knowledge level that will be recognized by physicians and other health care team members. The new practitioner must incorporate higher order thinking skills attained at the doctoral level. Building upon the essential body of knowledge, the clinical laboratory doctorate will transform laboratory data into an information product that can be used to: a) manage patient education and compliance; b) produce, validate, interpret, evaluate, and communicate diagnostic and therapeutic laboratory information, as well as develop and promote standards for them; and c) synthesize, implement, and communicate decision-making algorithms based on evidence.

How is this viewed from a graduate education perspective? (Professional researcher vs. researching professional, professional scholar vs. scholarly professor, teacher vs. professional, academy vs. industry)

From a graduate education perspective there may not be consensus among various healthcare constituencies and groups as to the role and responsibilities of the clinical doctorate across a number of different professions. Perhaps what is most readily agreed is that the PhD is regarded as the highest degree granted by the academy. Debate and discussion is currently ongoing within various colleges and universities as to whether a clinical doctorate can or should have rank among the professoriate as full faculty or rather that it be on a clinical faculty track. Depending upon the type of academic institution (research-doctoral, doctoral, masters, comprehensive, etc.), opinions vary greatly as to what constitutes "Faculty" in higher education.

The clinical doctorate practitioner will be expected to utilize research findings to advance the practices of the laboratory. This individual may participate in research activities, but that is not the principal aim of the clinical doctorate degree.

How much is the changing health model driving change in this profession?

Health Care delivery is undergoing rapid transformation, and the professions that contribute to the overall health care system need to adapt or they will be subsumed and become irrelevant. The health care industry has become highly technological and increasingly information-driven. Some professions have strategically planned and positioned themselves to meet current needs. Issues of access, health care disparities, payer systems and consumer-driven health plans, plus a greater focus on prevention and wellness are all driving system change.

The changing health model affords the clinical laboratory profession with an opportunity to produce a doctoral prepared individual with broad consulting skills who is able to move outside the physical boundaries of the laboratory to function as a more patient-oriented professional. This individual will provide the needed patient advocate in the laboratory, and will contribute to improved patient outcomes and patient safety. Such an individual will be involved with promoting better test utilization and test evaluation.

If the future of health care is based on a team model, how does this contribute? Does it not perpetuate silos? Is this degree creep?

Almost all of the health professions which have or are moving towards a clinical doctorate degree cite numerous multidisciplinary and interdisciplinary reasons that contribute to a rationale for higher degrees. It is evident that there needs to be better communication and interaction within the health care team.

The clinical doctorate will supply a bridge between the laboratory and providers. It will provide for a new practitioner. It neither raises entry level nor is it degree creep but will provide a career ladder and career enhancement, thus supporting a mechanism to retain the best and brightest in the laboratory profession.

Can the value added be clearly defined? Will it translate into better practice?

With the proposed clinical doctorate for CLS being an accredited program of study, minimal competencies will be assured through accreditation Standards. To achieve better practice, it will be critical that the clinical doctorate produce a broadly educated individual who will be able to consult in a manner that encompasses all areas of clinical laboratory testing and is not limited by sub-specialization.

Not all the value associated with the clinical doctorate will be measurable, with some aspects being intrinsic and guided by perception. Value associated with this level of practice may include but is not limited to improved quality of medical care via: improved reflex testing, reduction in medical errors, participation in interpretive rounds, functioning as a clinical consultant, developing of laboratory medicine algorithms and application of them to individual patient cases, process improvement, and consultation on health policy development. Implementation of such interventions to improve the quality of medical care will translate into better practice. It will improve inter-professional interface, foster the team role, and add robustness between the laboratory and clinicians.

Top of the News
			A Clinical Doctorate for the Laboratory
			Process and Outcomes of the NAACLS Graduate Task Force
			The Concept of the Clinical Doctorate in Clinical Laboratory Science: Role, Responsibilities and Education
Features
			A Pathologist's Perspective The Doctorate in Clinical Laboratory Sciences: The Time Has Come by Larry H. Bernstein, MD
			A Pathologist's Perspective The Clinical Doctorate: A Boon to Pathologists by Linda B. Piller, MD, MPH
			Evaluation of Participant Reactions to Stakeholder Meeting
Other News
			Background to Development of the Clinical Doctorate Initiative
			FAQs
			Next Steps in Development of Standards
			Planning for the March 1, 2006 Stakeholder Meeting
			Process Employed at the March 1, 2006 Stakeholder Meeting

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