The Changing Landscape of Laboratory Medicine
There are several issues facing the field of laboratory medicine right now:
- The influx of laboratories and capacity specifically for COVID testing.
- The shortage of trained and qualified testing personnel.
- The larger shift within healthcare away from fee for service and towards an integrated care/value-based model.
The question is how do smaller, independent labs, without the capital backing of a huge corporate enterprise or a hospital, survive the seismic shifts that are coming? I think each issue needs to be addressed individually. In this series of three articles, I will share my thoughts on each issue and how it might be addressed (there's never only one way to do anything, right?).
- What happens when COVID volume drops precipitously?
You're fooling yourself if you think COVID testing is here to stay, at least at current throughout. While COVID itself may not be going anywhere anytime soon, it would surprise me if the testing levels didn't shift to resemble flu testing. There will likely come a time when COVID is accepted as another flu-like illness; as with the flu, each year a number of people will contract it and a number of people will die and THAT will be the "new normal".
In line with that, laboratory testing will only be requested for symptomatic patients as opposed to the current level of asymptomatic surveillance. What, then, happens to all the small laboratories that opened their doors for the sole purpose of COVID testing?
Did you know that only 3.4% of clinical laboratories are in hospitals? That number surprised me. While the majority of CLIA accredited laboratories are physician office labs (41.6%). A staggering 14.5% are commercial laboratories. As those data are from 2020, its difficult to say how many of those are a direct result of the COVID-19 pandemic driven need for increased capacity and ultra-rapid turnaround time. But I bet it’s a lot of them. So, how do they manage a precipitous drop in COVID testing?
The obvious answer is that a lot of them will not survive. Those that are determined to do so will need to get creative!




