Volume 92 - Special Edition	Download

A Pathologist's Perspective The Clinical Doctorate: A Boon to Pathologists by Linda B. Piller, MD, MPH

Work is proceeding through NAACLS on the establishment of a Clinical Doctorate degree in Laboratory Sciences. Based upon a model already in place in pharmacy, these doctoral level professionals would serve as part of the clinical care team on hospital floors, in the outpatient setting, and in the clinical laboratory. In the laboratory the clinical laboratory specialist would function as the liaison between the patients' medical care team (composed of physicians and nurses attending to the patients) and the clinical laboratory, and as such would not only be involved in interpreting and communicating laboratory results but would also facilitate appropriate testing and test preparation. Benefits to patients are clear: they would have an expert in laboratory sciences working with their physicians to determine the most necessary and efficacious laboratory tests to perform, and to appropriately interpret the results vis-à-vis patients' medications and clinical circumstances.

However, how would these clinical laboratory specialists fit in alongside clinical pathologists? Further, how would clinical pathologists perceive and receive these professionals? The overall understanding of the role of the doctoral level laboratory specialist is key to these questions. Pathologists are involved in a myriad of activities and duties. These include obligations to the hospital administration and anatomic pathology laboratory, overseeing the clinical pathology laboratory, conducting molecular and genetic research and applying principles of higher-level molecular and genetics to their practices. The pathologist remains the consultant to clinical colleagues and the teacher of medical students, residents and fellows, and practicing physicians. Indeed, these functions more and more force the pathologist to relinquish valuable time previously spent with physicians as they visit patients on the hospital wards or in discussion with physicians regarding laboratory testing and interpretation. Pathologists cannot continue to answer every call for their expertise: it is time to recognize that which can be shared with well-trained and appropriately credentialed colleagues. The development of a clinical doctorate degree in laboratory sciences will provide a new member to the health care team who can relieve the pathologist of clinical laboratory consultation and patient care duties. Moreover, given the increasing specialization in all medical fields, including pathology, the clinical laboratory specialist would offer an additional measure of knowledge, training, and overall expertise regarding laboratory testing. The specialist would be a member of the medical care team, just as the pharmacist has become on hospital rounds, and would be the physicians' and patients' chief consultant regarding appropriate ordering and interpretation of laboratory test results. The endpoints would be improved patient care, lowered medical costs with the elimination of unnecessary testing and its replacement by the most appropriate laboratory regimen, while relieving the pathologists of patient care burdens relating to the clinical laboratory. Everyone would win and no one would lose.

Will this be accepted by pathologists universally? Probably not in the short-term. But with time and a concerted effort to work side-by-side with, and not against, each other, pathologists and clinical laboratory specialists can improve the quality of care for patients and lower the cost of healthcare.

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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