Goodbye Clinical Labs! Hello Genetic Testing Labs!

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IS THE CLASSIC MODEL OF THE INDEPENDENT PATHOLOGIST-OWNED CLINICAL LABORATORY that is the sole source provider of all routine, reference, and esoteric testing to physicians in its community on its way to extinction? There is strong evidence to support a “yes” answer to that question. 

The heyday of the local, pathologist-owned independent lab company was the 1980s and 1990s. That’s when every city and town had a least one or two of these labs. They provided a full soup-to-nuts test menu and their clinical pathologists personally knew the referring physicians and were familiar with many patients, particularly those with chronic diseases. 

In the early 1990s, it was estimated that 5,000 independent clinical lab companies operated in the United States. Those days are over. Beginning about 1985, publicly-traded lab companies began buying those pathologist-owned lab companies. In 2021, it can be challenging to find a pathologist-owned independent lab company that performs all the routine, reference, and estoric testing for its clients. 

Instead, the clinical lab industry has a new engine of growth—companies that specialize in genetic testing. Starting about six to eight years ago, the number of new genetic test company start-ups began to increase. Many of these new enterprises have proprietary or patent-protected genetic tests. 

Meanwhile, the need for local routine and reference testing has been filled by two primary types of labs. One type are the hospital and health system labs that provide routine and reference testing to the outpatient and outreach providers in their communities. The other type are the handful of billion-dollar public lab companies, including Labcorp, Quest Diagnostics, BioReference Laboratories, and Sonic Healthcare. 

Of course, it is facetious to say “goodbye clinical laboratories.” The need for routine and reference testing will continue. The point here is that the profession of laboratory medicine has lost the benefit of a local clinical pathologist running his or her independent lab company in ways that benefit physicians and patients in that community. 

In its place, either a local hospital lab or a national public lab company now provides those routine and reference testing services. Meanwhile, genetic testing is the sector of laboratory medicine experiencing explosive growth. TDR

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