COMMENTARY || Cancelling superlab undermines foundation of patient care
Lab physicians may work behind the scenes, but equipping them properly to provide fast and accurate test results is vital to health care, argues U of A physician.
By CHERYL MATHER
You don’t know me, but I’m your doctor. I am one of hundreds of physicians trained in laboratory medicine who work to provide you with accurate and timely test results that help your “real” doctor decide whether you have celiac disease or the stomach flu, influenza or lung cancer.
Though we will likely never meet, I am dedicated to taking care of you and your family. Lab testing is not a luxury of medical care; it is the foundation. Cancelling the Edmonton “superlab” to focus on “taking care of patients” suggests that my profession doesn’t care about the people we serve. Nothing could be farther from the truth.
You may think that lab test results appear magically; blood goes in little tubes and the answers come out a few hours or days later. You may think that these answers are automated and absolute. In reality, there are thousands of people working to make sure that the results you get are correct and that they get to your doctor when they’re most needed.
Many results are generated by automated machines, but they are validated and verified by people. Some tests are more complicated, requiring specially trained people to interpret the results.
If you have cancer, your medical journey usually starts with a tissue biopsy. The tissue is sent to pathologists—laboratory physicians who look at it under the microscope and decide whether there is cancer and what kind it is.
After the diagnosis you see an oncologist to figure out whether you need surgery, radiation, chemotherapy, or other treatment. This decision is not made in a vacuum. Your oncologist may call the lab and ask for special genetic tests.
My lab can test your tissue for mutations that would make you eligible for therapies that might extend your life by years. These tests require highly trained technologists, expensive equipment, and specially trained physicians. Interpretation is not always straightforward. I’ve trained for more than a decade to ensure that I give you the right answers.
The science of medicine is advancing rapidly, especially in cancer genetics. The number of mutations that can be treated with special therapies is growing daily, but front-line clinicians who treat patients can’t use these drugs unless they know whether the mutations are present.
My lab must keep up with these advances; we’re working every day to bring on new, more accurate and faster tests. The unfortunate truth, however, is that we do not currently have the space, manpower or infrastructure to do the best job that we could. Our facilities are built for a bygone age; we’ve no space for new equipment, and the equipment that we’ve squeezed into place to meet the standard of care produces labs that are hot, noisy and crowded.
The Edmonton Hub Lab was supposed to provide needed improvements in infrastructure that would allow us to keep up with the demands of advancing medicine and grow to provide even better care for patients that count on our results. This facility was not an indulgence; it was the best option to improve our ability to offer care. Now that the Hub Lab is gone, we are stuck scrambling for bench space and internet ports to bring in needed equipment.
Without substantial investment into lab services, patients in northern Alberta will be left behind as medicine advances. This breaks my heart. I went into medicine because I wanted to improve lives. I went into the lab because it was the best way for me to improve care for the most people.
When we shortchange the lab, all patients suffer. It is easy to view the lab as a faceless entity that doesn’t need “extra” money, but by undermining the lab, we chip away at the foundations of medicine and tie the hands of the “real” doctors who see you in the clinic and the hospital.
You wouldn’t want to accept suboptimal care from your oncologist because they can’t get the results they need. Investment in the laboratory is investment in patient care. There are more than a hundred others like me in Edmonton alone, working behind the scenes.
Laboratory physicians aren’t the doctors that you meet in the clinic, but we’re doctors all the same. If nothing is done to improve the lab, we will reach the limits of our ability to provide care.
Cheryl Mather is a clinical assistant professor of anatomic and molecular pathology at the University of Alberta, Alberta Public Laboratories.
This opinion-editorial originally appeared July 3 in the Edmonton Journal.