Is laboratory medicine a dying profession? Blessed are those who have not seen and yet have believed.

Technological developments and economic drivers have led to major changes in clinical laboratories worldwide, principally represented by an increase in testing productivity and efficiency. Currently, major expectations are entrusted on the introduction of diagnostically more effective tests as well as on translating the "omics" techniques into the clinical practice. However, the increased automation and standardization have far outpaced the laboratory professional involvement in assuring optimal test utilization and interpretation. While productivity of 'commodity' testing increases, the value of laboratory services seems to decrease contextually. This development represents a serious threat for laboratory medicine as an academic discipline not only because the laboratory professionals may lose the direct control of the commodity testing production activities but also because the present evolution exposes a failure of our core clinical activities, that is and remains the translation of laboratory data into valuable information for improving patient's outcomes. At a time when a revolution in healthcare organization is virtually unavoidable in the years ahead, clinical laboratories must proceed from a merely reactive strategy to a more proactive role in patient care. As patient-centered care is increasingly recognized as a primary focus in reorganizing the delivery of healthcare services, integrated practice units organized around the patients' needs and medical conditions are needed. An effective strategy to overcome the current inefficiencies in the delivery of laboratory services should encompass translation into integrated, multidisciplinary care, in which appropriateness in test request and interpretation both play a central role in assuring efficiency and effectiveness. 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.