Sunday, August 8, 2010

Welcome to the new laboratory?

I was reflecting with my colleagues the other day about how much laboratories have changed (in Canada) over the last few decades.  There was a time not that long ago when a laboratory had a General Pathologist Medical Director and that was it as far as medical leadership was concerned.  Gradually the number of medical laboratorians increased with a focused haematopathologist, or two, a clinical chemist (or 2) and a medical microbiologist, and a number of anatomic pathologists who focused their career around an organ system.  The laboratory was discipline oriented, but with more depth of senior expertise.  This all made a lot of sense because there were few technical or interpretive links between what the disciplines did, or how they interpreted their information.   
Note: these musings are not intended to be pejorative or dismissive of laboratory technologist.  See the next, or near next, posting.
But then around 1990 or so, everything started to change, first with the development of common technologies like immunoassay systems for antigen detection, and hormone detection, and increasing analyzers and automation in both haematology and chemistry.  The notion of distinct disciplines was starting to fade.
Today while we still focus our training programs in an increasingly archaic discipline structure, the laboratory is not only become more homogenized from a laboratory testing perspective, new foci of attention are growing rapidly.  Today there are folks (like me) that focus most of their attention on the broader aspects of quality, and others whose time is almost exclusively in administration, and others who exclusively do infection control, and others whose area of interest is all about molecular diagnosis that crosses every cusp that used to exist.
So we have become more and more specialized in what we do, but very little in a way linked to our traditional base.  I suspect that this is a trend that is not going to go away, and that as the years go by our foci of attention will still be more specialized and more cross discipline than ever before.
From my self-absorbed perspective, this is a good trend.  Laboratories will improve with the dedicated attention of management review, quality mission, internal audits, meaningful accreditation preparation, quality culture development and of course monitoring of indicators including costs of quality.
 So does that mean the number of quality focused laboratorians will increase  (a qualitologist?). 
Maybe.   I hope so.
PS:  Training programs better start to wake up.  As Bob Dylan opined, "the times they ARE a-changing". 

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