Mike Addison: 
> >It is my contention that Pathology is an integral part of patient care and 
> >that contact between the lab and the medical staff is as 
> >important a part of the service as the analytical function.   These 
> >contacts are best achieved by face to face contacts.  
> > My personal experience is that the need for constant proactive 
> > contact with medical staff is increasing 
Trevor Gray:
> I couldn't agree with you more, as I feel that pathology must be
> proactive and interactive to provide the optimum help to our colleagues.

I agree too.  I've never met, or heard of, a clinican who wants less 
contact with the lab - they all want more, and it's up to us to 
provide it, and justify it to anyone who implies that it is not 
fundamentally and increasingly important.  Getting explicit support 
in this from clinicians would strengthen our case.  

We should also incorporate skills for clinical liaison more explicitly 
into clinical scientist training, right from the start.  They want it and 
the service needs it.

Perhaps we should also look objectively at "megalabs" (depending 
on how they are defined), rather than seeing them purely as a 
threat.   Technology is developing fast and this will have a huge 
impact on near patient testing, for example.  Those labs who have 
been unwilling to work with clinicans on NPT - which then may get 
implemented anyway in an uncoordinated way without the lab's 
involvement - may be losing an opportunity to be seen as essential 
partners in service developments which maximise quality 
(analytical and clinical) and minimise cost.  

Many hospital general managers are very ignorant about what we 
do and why things are organised as they are;  they can therefore 
see pathology as a "bolt-one" extra cost which can be easily 
identified and cut.  Working strategically with clinical, planning and 
financial colleagues elsewhere in the hospital on planning and 
implementing service developments in their totality is surely the 
way for us to succeed in convincing them that pathology is, as 
Mike says, an integral part of patient care.  Decisions on how the 
service should be developed - analytically and clinically, by NPT or 
on-site lab, or even the nearest "megalab", can then be discussed, 
emphasising quality, cost and staffing implications - general 
managers often have an abysmal understanding of real costs, for a 
start.  

In the real, bad old world, there will still be plenty of bean-counters 
who are out to get us, and I'm all for a bit of healthy cynicism, but 
I'm sure we could help our own case more.
 

Dr MJ Pearson
Department of Clinical Biochemistry & Immunology
Old Medical School
Leeds General Infirmary (Leeds Teaching Hospitals NHS Trust)
LEEDS LS1 3EX

Tel 0113 392 3945


%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%