Even in a global pandemic, there’s no such thing as a crisis

In my 2019 publication, Constructing Crisis: Leaders, Crisis, and Claims of Urgency, I argued that “crisis” is a label, a claim of urgency employed, typically by leaders, to characterize a set of contingencies that are, together, taken to pose a serious and immediate threat. I then proposed a typology for sorting through any such claim in order to reach a judgment concerning the legitimacy of the claim. Classification systems such as typologies are foundational to knowledge creation in that they enable pattern recognition.. How we classify phenomenon has a real impact on how we consider and behave in response to that phenomenon. In the context of a global pandemic, the importance of critical judgment is especially salient. Labeling the global pandemic as a crisis may be non-controversial (to most). But there are enumerable claims being made under the general rubric of that pandemic that are not nearly so widely and easily accepted. Furthermore, claims of urgency will continue long after this particular contingency passes. It is never advisable to relax a critical perspective, especially when assertions of power and interests are involved and the stakes are so high.

Essential role of laboratory physicians in transformation of laboratory practice and management to a value-based patient-centric model

The laboratory is a vital part of the continuum of patient care. In fact, there are few programs in the healthcare system that do not rely on ready access and availability of complex diagnostic laboratory services. The existing transactional model of laboratory "medical practice" will not be able to meet the needs of the healthcare system as it rapidly shifts toward value-based care and precision medicine, which demands that practice be based on total system indicators, clinical effectiveness, and patient outcomes. Laboratory "value" will no longer be focused primarily on internal testing quality and efficiencies but rather on the relative cost of diagnostic testing compared to direct improvement in clinical and system outcomes. The medical laboratory as a "business" focused on operational efficiency and cost-controls must transform to become an essential clinical service that is a tightly integrated equal partner in direct patient care. We would argue that this paradigm shift would not be necessary if laboratory services had remained a "patient-centric" medical practice throughout the last few decades. This review is focused on the essential role of laboratory physicians in transforming laboratory practice and management to a value-based patient-centric model. Value-based practice is necessary not only to meet the challenges of the new precision medicine world order but also to bring about sustainable healthcare service delivery.