How do I advertise a clinical laboratory

In the medical laboratory, body fluids (blood, urine, stool, liquor, aspirates, smears, etc.) and tissue are examined for certain parameters or questions. The laboratory doctor must first check whether the request makes sense and, if necessary, consult the doctor in charge. The analysis results are then checked for plausibility by the laboratory doctor, an interpretation of the findings is made, suggestions / information on further diagnostics (step diagnostics, differential diagnostics) and, if necessary, on therapy are given.

The aim of any laboratory analysis is to deliver correct laboratory results as quickly as possible. In the event of highly pathological findings (e.g. in the event of a heart attack, coagulation disorder, bleeding), the laboratory doctor is required to inform the clinical doctor immediately. Recognizing such Emergencies often requires good experience, because the “red highlighted” laboratory value in the computer program alone is not always sufficient as an indication.

Examples from everyday diagnosis that the laboratory doctor needs to clarify further:

  • Is the low Hb value “only” due to (deficiency) anemia or is it due to acute bleeding, leukemia, a congenital hemoglobin synthesis disorder or is it ultimately just a preanalytical error in the blood collection on the Station / in practice?
  • Does the abnormal IgM finding in the infection serology really suggest an acute infection? Or are these IgM antibodies that persist for a long time and have no clinical relevance? Can further analyzes be connected for verification? Does the attending physician have to be informed about important consequences (reporting obligation, therapy recommendation, etc.)?

The consulting service of the laboratory doctor

The laboratory doctor does not give therapy - the attending physician does that - but as a “diagnosis maker” or “interpreter of findings”, he is usually decisive for the clinician's further decision. The laboratory doctor therefore has a great responsibility for the well-being of the patient. He stands for Consultations with the clinically active doctors to disposal. The laboratory doctor's consulting activities are carried out by telephone or, if necessary, as part of a ward round. During the working day, for example, he receives calls from clinically active doctors who want advice or have a request for an analysis.

The consultative Consulting service of the laboratory doctor concerns, among other things:
- the indication - e.g. meaningful requirement of parameters, stage diagnostics
- Compliance with a correct preanalytics - e.g. which tube is necessary, which acceptance conditions (sobriety, time, physical rest, etc.) are necessary, etc.
- Questions about the assessment of the laboratory results, questions about the further differential diagnostic procedure, sometimes also questions about therapy

Work in an interdisciplinary team

The laboratory doctor deals because of the diagnostic manifold with different disciplines, among others: Hematology, Clinical Chemistry, Immunology, Microbiology, Molecular Biology, Human Genetics, etc. Therefore belongs to the Cooperation between the laboratory doctor and an interdisciplinary team from other specialist and non-medical staff to everyday life in the medical laboratory. These include, for example, natural scientists, medical-technical laboratory assistants (MTLA), medical-technical assistants (MTA), transfusion specialists, human geneticists, microbiologists, etc.

Delegation of certain tasks to specialist staff

The laboratory doctor may delegate certain laboratory tests under his guidance and supervision to appropriately qualified personnel. This applies to what is referred to in professional jargon Routine work in the laboratory, such as:

- the acceptance of the samples, checks of the sample quality and allocation in the individual analysis areas
- the feedback to the requesting doctor in case of ambiguity or problems with the sample
- the loading of the analysis machines with the samples or the execution of examinations
- the quality controls and corrections of the analytical equipment
- the technical validation, i.e. the analytical assessment of the test results

However, the work in these areas is always instructed or monitored by the laboratory physician. If the results are unclear or pathological, the laboratory doctor is often called directly “to the machine” to check the result. Of course, especially during the specialist training, it is necessary for the assistant doctor to also take on the tasks of the MT (L) As, e.g. microscopically (blood) smears himself or prepare microbiological preparations himself. It is precisely then that you can benefit from the great knowledge of the MT (L) As.

The laboratory doctor's workplace, the medical laboratory

The laboratory doctor works in the medical laboratory, which is available in both outpatient and inpatient areas. There is a link to a detailed article below about the different medical laboratories. Some large laboratories and university hospitals also have the Research and Teaching on the everyday life of the laboratory doctor (see experience reports; link below).