The world of laboratory medicine has undergone many changes in recent years, and a panel of six highly regarded laboratory professionals discussed them in “The Changing Face of Laboratory Medicine: A More Service and Less Academically Oriented Profession?,” a Q&A in the February issue of Clinical Chemistry. Efforts to reduce the cost of healthcare and laboratory testing over the years led to the consolidation of labs, outsourcing, and hostile takeovers in the mid-1990s. That led to fewer clinical laboratory director positions, downsizing of postdoctoral training programs, and the closure of some medical technology schools.

“Furthermore, the regulatory requirements, quality assessment programs, compliance issues, and general administrative responsibilities of laboratory directors have significantly increased over the past decade. As a result of these clinical service demands, the academic aspects of the profession and the time to participate in research have seemingly suffered,” wrote Mitchell Scott and Nader Rifai, who moderated the Q&A. “For instance, fewer clinical laboratory physicians and scientists are publishing in top journals such as Clinical Chemistry, where currently only approximately 35% of original reports have a first or last author associated with a laboratory medicine or pathology department.”

The article goes on to get perspectives from the six participants—who hail from the U.S., Germany, Italy, Australia, and the UK.—on the ramifications of these changes on laboratorians and what can be done to help reverse the trend.

Most participants said they were hopeful about the future of laboratory medicine.. “Despite all the challenges we face, laboratory medicine physicians have to play a clear leading role in the application of emerging biomarker technologies and the management of complex laboratory structures,” said Michael Oellerich. “Therefore, I am optimistic that the current pace of innovation, flood of new technologies, and advances in molecular diagnostics provide an environment in which laboratory medicine as an academic profession has a chance to grow.”

Like Oellerich, Fred Apple also sees a bright future for the field. “I am optimistic about the future of laboratory medicine as an academic profession, as we have more skill sets at our disposal than ever before,” he said. “However, my concern is if we, as clinical chemists/pathologists, do not train our students with the appropriate skills, other nonlaboratory disciplines will slowly take away our clinical and technical responsibilities.”

Others were not so sanguine. “In the UK, it is difficult not to be pessimistic, as the focus of laboratory medicine does not readily lend itself to achieving academic success in the university system,” said Ian Young. “There has been a progressive loss of identifiable laboratory medicine departments in universities, and individuals from a laboratory medicine background often achieve their academic success in other units. However, even if laboratory medicine may struggle as a separate academic discipline, there are still considerable opportunities for talented individuals who wish to make research their focus.”