The Clinical Laboratory Tour

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Just what is the clinical lab all about? What do they do and who are the people who work in the labs? This question pops up in the minds of not just the general public but also many physicians, nurses and other health care providers. Of all the departm ents in the hospital none is more mysterious or shrouded in misconception then the laboratory. Yet most hospital patients can't even get an ingrowing toenail removed without a battery of lab tests and the average person on the street has probably had at l east one blood test drawn as an outpatient or in their doctor's office. Come with me as I take you on a tour of a clinical hospital laboratory.

The people of the clinical laboratory

Who works in the lab and what are their qualifications and educational background?

Pathologist: The pathologist is the physician member of the laboratory staff. They are an MD who has completed a 4 year residency program in pathology including clinical pathology (the medical and labo ratory aspects of disease) and anatomical pathology (the gross and microscopic examination of organs, tissue specimens, microscope slides, autopsies, etc.). In most states and in all hospital labs the director of the laboratory is a pathologist.

Clinical Scientist: These are the individuals who manage and supervise the technical aspects of the clinical lab. They typically have graduate degrees and those in large university hospitals will usual ly have a Ph.D. Besides the day to day management of the laboratory section they supervise, they are responsible for the evaluation and implementation of new methods, instruments, and technologies. Those is academic institutions will develop new test proc edures and research their use and interpretation.

Pathologist's Assistant: The Pathologist's assistant performs gross examination of tissue specimens such as surgically removed tumors, diseased organs, etc. They will also prepare frozen tissue section s for the Pathologists review and will dissect specimens for further microscopic examination. The Pathologist's assistant has a 4 year degree in pathology with additional post-graduate training in an approved PA program.

Medical Technologist: The medical technologist has a 4 year degree in a scientific discipline. Many of these BS degrees are in Medical Technology. The university medical technology programs include ext ensive courses in the principles and interpretation of laboratory tests as well as their relationship to disease. Included in the 4 year program is a 6-12 month rotation in a hospital laboratory. Most graduates of these programs will take a national certi fying examination given by the American Society of Clinical Pathologists (ASCP). Those who pass the exam may use the letters MT(ASCP) after their name. The medical technologist performs the tests in the lab and makes decisions involving the evaluation of results and quality control before they are released to the physician. In addition, the "med tech" answers physicians questions and maintains and troubleshoots complex instrumentation.

Laboratory Technician: The laboratory technician has a 2 year degree, usually in a specialized program in laboratory technology. The lab technicians work side by side with the medical technologists in performing most of the tests. In practice, the technician performs about 98% of what the technologist does. The main difference, besides pay, is that the technician's work is usually reviewed by a supervisor or technologist before release.

Phlebotomist: The phlebotomist is frequently the only laboratory employee most patients see. They are the laboratory employee who draws blood from the patients (the name means "one who removes blood"). A phelbotomist will typically have a high school diploma and will have undergone an approved training course in phlebotomy.

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