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ACB-CLIN-CHEM-GEN  2006

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Subject:

Re: AMA Wants Physician Oversight of Diagnostic Interpretation

From:

"TICKNER TREVOR (RM1) Norfolk and Norwich University Hospital" <[log in to unmask]>

Reply-To:

TICKNER TREVOR (RM1) Norfolk and Norwich University Hospital

Date:

Thu, 21 Dec 2006 12:48:04 -0000

Content-Type:

text/plain

Parts/Attachments:

Parts/Attachments

text/plain (179 lines)

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

  

  

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