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I must confess my reading (subsequently expressed by Roger) was that this is about preservation of status and income. It is quite natural for us to try to preserve both but in doing so there are dangers, not least in our presumption concerning 'diagnosis.' Many diagnoses are descriptive observations (e.g. pityriasis rosea), conjecture (carcinoma-in-situ), eponyms (remember Bright's disease?) or presumed pathological mechanisms. As such they are subject to change and that change can as well come from those employed outside healthcare as those within it. Worse, advances may come from those without the 'appropriate' formal qualification. Interdisciplinary barriers do little to advance knowledge or quality of care and while the aim of CPA is, quite properly, to protect patients, its standards may also be used to protect some and inhibit others. The ultimate test of the validity of any accreditation standard must be whether it can be shown to enhance patient care. Trevor -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Myers Martin (Dr) Sent: 21 December 2006 12:14 To: [log in to unmask] Subject: Re: AMA Wants Physician Oversight of Diagnostic Interpretation I agree with Steve. The situation in the UK is different to the USA and the Consultant Clinical Scientists in the UK have MRCPath as well as a scientific qualification. Training for Clinical Scientists in the UK includes the knowledge required to make diagnostic interpretation. The Clinical Pathology Accreditation (CPA) body in the UK has a standard that defines what competences are required at the highest level in the laboratory (see below) and, in part, the CPA B1 standard already reflects the AMA concerns. For Clinical Governance reasons it would be unlikely that CPA would change this standard especially in light of the debate in the US. Happy Christmas Martin Myers B1 Professional direction: Professional direction is essential for the proper performance of a laboratory. B 1.1 Each discipline shall be professionally directed by a consultant pathologist or clinical scientist of equivalent status. Competence shall be demonstrated in the following ways : a) by evidence of training and experience in a pathology specialty as normally exemplified, in the United Kingdom, by membership of the Royal College of Pathologists or its equivalent. (Taken from CPA UK) -----Original Message----- From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of Frost, Stephen Sent: 21 December 2006 10:55 To: [log in to unmask] Subject: Re: AMA Wants Physician Oversight of Diagnostic Interpretation Ridicule aside, I think you are over-interpreting 'supervision'. I suspect the AMA idea may be to have one or a few medics (probably more or less as now) in each 'Pathology' (Laboratory Sciences?)Department. Rather similar to us in UK, except of course we have a few Consultant Clinical Scientists as well (usually clinically trained to MRCPath standard, with our lower emphasis on PhD). As a PhD is of itself no guarantee of clinical competence, I would have thought formal clinical supervision may be a good idea. We in the UK usually follow America so we need to be sure of our preferred wording and not just accept the American version (no disrespect). Merry Christmas Steve ----- > -----Original Message----- > From: Clinical biochemistry discussion list > [mailto:[log in to unmask]] On Behalf Of David Bullock > Sent: 20 December 2006 11:27 > To: [log in to unmask] > Subject: AMA Wants Physician Oversight of Diagnostic > Interpretation > > > For scientists of a pessimistic bent: > > "The American Medical Association adopted a new > policy in November > stating that a PhD clinical laboratory scientist or > other non-physician > lab > personnel should work under the supervision of a > physician to perform > tests > that will be the basis for a diagnostic > interpretation" > > http://www.ama-assn.org/amednews/2006/12/04/prsd1204.htm > > > Happy Christmas! > > David > > Dr David Bullock > Director, Wolfson EQA Laboratory > P O Box 3909, Birmingham B15 2UE, U K This message and any files transmitted with it are confidential and intended solely for the individual(s) addressed. 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