VALUE-ADDED LABORATORY MEDICINE IN AN ERA OF MANAGED CARE

Clinical laboratory consultants (M.D.s and Ph.D.s) must add value and medical relevance to the healthcare system to earn and maintain their roles in an era of managed care. Service opportunities include new and expanded roles in system-wide (a) managing of point-of-care testing, (b) informatics and information systems, (c) clinical consultation, (d ) resource management, (e) management of utilization, (f) improving he althcare quality assurance, and (g) technology assessment and implemen tation. Hypothesis-driven research focused on the linkage between the laboratory and outcome analysis, clinical practice guidelines, total q uality improvement, technology assessment, and healthcare policy provi des major opportunities to compete for expanding research support. Cha nges in clinical laboratory consultant training are necessary to provi de the knowledge, skills, and experience required to provide value-add ed and medically relevant services. Clinical laboratory consultants wi th Ph.D. degrees should initially be trained broadly in all areas of t he laboratory, with emphasis on system-wide issues, and then trained a s specialized scientists.