Physician's office laboratorians: What do they do? How should they be educated?

Federal legislation limiting Medicare reimbursement to hospitals is likely to reduce revenues available for clinical laboratories, a development that has caused clinicians, laboratorians, and educators concern over its effect on the quality and availability of laboratory testing. As educators we must be aware of external forces on and trends in laboratory testing that may alter the future role of the medical technologist. An objective type survey was sent to 867 private practice Texas physicians to determine the status of laboratory testing after the DRG system was phased into practice. Responses were received from 140. Although some physicians indicated that changes in Medicare reimbursement has caused them to order fewer tests, others indicated thay were sending more tests to reference laboratories or had started testing in their offices. Laboratory testing in the physician's office was performed by a variety of healthy professionals who were also expected to perform other medical procedures and office duties. In order to take advantage of the expansion of physician-office laboratories, medical technologists will need to acquire multidisciplinary skills. The education process could be changed to allow students the opportunity to develop the additional skills needed to become marketable in this area.