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September 9, 1988

The Alteration of Physicians' Orders by Nonphysicians-Reply

Author Affiliations

State University of New York at Stony Brook

State University of New York at Stony Brook

JAMA. 1988;260(10):1404. doi:10.1001/jama.1988.03410100093019

In Reply.—  We believe that the choice of laboratory test, or test regimen, must be made by the physician. The purpose of ordering—or, preferably, requesting—a laboratory test is to confirm or exclude clinical impressions with sufficient certainty to ensure that clinical management does more good than harm. This is the essence of laboratory medicine and in our view is best achieved by consultation between clinical pathologist and practicing physician. In recent years we have come to appreciate the concepts of diagnostic value and clinical usefulness as they apply to laboratory testing.1 Nevertheless, it is important to realize that test strategy may be rendered meaningless if requests are improperly transmitted, blood samples are improperly obtained, analyses are inaccurate or imprecise, or results are reported incorrectly. To ensure the quality of the foregoing requires well-trained and dedicated medical technologists. We agree with Dr Meyer that in the interest of improving laboratory