I must respond to Alan Bromley's riposte.
The decision about performing a test out-of-hours is based on
clinical need and the economics of laboratory function. The clinical
need is based on a combination of general opinion and negotiation
between the laboratory and the client clinicians. This is done in the
cold light of day and is usually generalised for all patients.
However, under the stress of a particular patient and a worried
medic, then I do not believe that an MLSO would be able to refuse a
test and justify that action. The purpose of specific clinical
training for clinical scientists is to give that authority.
Often the easiest course of action is to do the test and use the
experience as an educational measure when the heat of a difficult
decision is over. Not all tests are possible at unusual times and as
Roy Fisher states.... todays exception becomes tomorrows rule...
Julian Barth.
Comment by Julian Barth:
After all most us have MLSOs analysing acute work and none of it is =
vetted by laboratory clinicians. MLSOs are not equipped with the =
training to question an unusual request.
As an MLSO I find that comment somewhat annoying and more than a little =
derogatory.
Perhaps the MLSO's (your MLSO's?) should be given the time and training =
which would enable them to question unusual requests.
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Julian H Barth
Department of Chemical Pathology & Immunology
Leeds General Infirmary
Leeds LS1 3EX
tel 0113-392-3416
fax 0113-233-5672
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