A Professional Doctorate in Clinical Laboratory Science?—Not so Fast

Extract

I'm delighted to read Dr Kathy Doig's editorial, “The Case for the Professional Doctorate in Clinical Laboratory Science (DCLS)”. As a practitioner and educator, I support every effort to elevate our profession. Further, Dr Doig is a professional acquaintance and friend whose opinion I respect.

Nevertheless, my self-appointed task is to poke holes in her proposal. Like most clinical laboratory scientists (CLSs), I work closely with clinical pathologists. The UAB Division of Laboratory Medicine employs eleven MDs, five with concurrent PhDs, and five non-MD PhDs; sixteen altogether. Of the five PhDs, two are microbiologists and three biochemists. One of the biochemists is a CLS. The whole pathology faculty (clinical, anatomic, and experimental) numbers 78.

At UAB, CLSs manage the laboratory in partnership with pathology. Our medical director, John A Smith MD PhD, calls it ‘matrix management’, an underused management approach. The pathology faculty draw on the CLSs as technical contributors to their practice, not as their employees—administratively, CLSs report to fellow scientists. A professionally favorable system, but with so many clinical pathologists around, CLS opportunities for rounding, committee work, and house staff interaction are limited. In fact, though they regularly attend rounds, anything the CLS may do that resembles consultation is discouraged—instead referring interpretations to clinical pathology faculty and residents. Why? They can charge for it under Medicare part B, the CLS cannot. UAB's PhD microbiologists and biochemists teach and consult frequently, however they are unable to charge through part B.

Not that the clinical pathology consultation system works all…