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October 25, 1995

Opportunities and Challenges of Laboratory Testing at Alternative Sites

Author Affiliations

From the Methodist Hospitals of Memphis (Tenn) (Dr Handorf) and the University of North Carolina, Chapel Hill (Dr McLendon).

JAMA. 1995;274(16):1308-1309. doi:10.1001/jama.1995.03530160060036

A 15th-century woodcut portrays a physician making a house call at the bedside of his patient.1 The physician's right hand is on the patient's pulse while he points with his left hand to a flask of the patient's urine held up to the light by an assistant. In observing the urine, the physician is practicing the art of uroscopy, that is, the attempted gleaning of knowledge of the patient's condition from the direct observation of fresh urine. The science of laboratory medicine advanced little from the 15th to the 19th century, whereupon the introduction of medical microscopy greatly advanced the ability of physicians to observe and diagnose patients. Scientific and technical advances accelerated in the 20th century, especially after World War II, with astonishing speed and breathtaking scientific elegance. These advances allowed a remarkable enhancement of the physician's ability to diagnose; however, they carried a price: the transfer of

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