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Orth M, Averina M, Chatzipanagiotou S, Faure G, Haushofer A, Kusec V, Machado A, Misbah SA, Oosterhuis W, Pulkki K, Twomey PJ, Wieland E. Opinion: redefining the role of the physician in laboratory medicine in the context of emerging technologies, personalised medicine and patient autonomy ('4P medicine'). J Clin Pathol 2017; 72:191-197. [PMID: 29273576 PMCID: PMC6580792 DOI: 10.1136/jclinpath-2017-204734] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 11/22/2017] [Accepted: 12/01/2017] [Indexed: 11/12/2022]
Abstract
The role of clinical pathologists or laboratory-based physicians is being challenged on several fronts—exponential advances in technology, increasing patient autonomy exercised in the right to directly request tests and the use of non-medical specialists as substitutes. In response, clinical pathologists have focused their energies on the pre-analytical and postanalytical phases of Laboratory Medicine thus emphasising their essential role in individualised medical interpretation of complex laboratory results. Across the European Union, the role of medical doctors is enshrined in the Medical Act. This paper highlights the relevance of this act to patient welfare and the need to strengthen training programmes to prevent an erosion in the quality of Laboratory Medicine provided to patients and their physicians.
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Affiliation(s)
- Matthias Orth
- Vinzenz von Paul Kliniken gGmbH, Institut für Laboratoriumsmedizin, Stuttgart, Germany.,Medizinische Fakultät Mannheim, Ruprecht Karls Universität, Mannheim, Germany
| | - Maria Averina
- Diagnostisk klinikk, Laboratoriemedisin, Universitessykehuset Nord-Norge HF, Tromsø, Norway
| | - Stylianos Chatzipanagiotou
- Department of Clinical Microbiology and Medical Biopathology, National and Kapodistrian University of Athens, Medical School - Aeginition Hospital, Athens, Greece
| | - Gilbert Faure
- Laboratoire d'Immunologie, Pole Laboratoires, Centre Hospitalier Universitaire de Nancy, Nancy, Lorraine, France
| | - Alexander Haushofer
- Klinikum Wels - Grieskirchen GmbH, Institut für Medizinische und Chemische Labordiagnostik mit Blutbank, Wels, Austria
| | - Vesna Kusec
- Klinicki Zavod za Laboratorijsku Dijagnostiku, Klinicki Bolnicki Centar Zagreb, Zagreb, Croatia
| | - Augusto Machado
- Department of Botelho Moniz Análises Clínicas, SA, Porto, Portugal
| | - Siraj A Misbah
- Department of Clinical Immunology, Oxford University Hospitals, Oxford, UK
| | - Wytze Oosterhuis
- Department of Clinical Chemistry and Haematology, Atrium Medical Center, PC Heerlen, Netherlands
| | - Kari Pulkki
- Department of Clinical Chemistry, Eastern Finland Laboratory Centre and University of Eastern Finland, Kuopio, Finland
| | - Patrick J Twomey
- Department of Clinical Chemistry, St. Vincent's University Hospital/St Vincent's Group Healthcare Group, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Eberhard Wieland
- Klinikum Stuttgart, Zentrum für Diagnostik, Zentralinstitut für Klinische Chemie und Laboratoriumsmedizin, Stuttgart, Germany
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