Saturday, July 18, 2015

I am a Medical Laboratory Scientist; what's that?

I have been asked over and over again, what do you do as a medical laboratory scientist in the United States of America?
While there might be no simple answer to this question, given the ever dynamism of the medical and healthcare profession, I will attempt to give a simple, but concise answer to the best of my ability based on my training under the College of Medical Sciences at the University of Calabar in Nigeria.

Very little is know about the profession of medical laboratory science especially by the patient visiting the hospital due to the fact that these professionals are kind of "Latent hero or investigators" that makes the duties and responsibilities of the visible physician and nurses not only easy, but in most cases factual, accurate and precise based on evidence based medicine. 



Hospital

A medical laboratory scientist is a professional who by training is responsible for the elucidation of diseases, ailment and causative factors through diagnostic means such as laboratory testing on urine, blood, saliva and other body fluides, and tissues.

When you visit your doctor for instance, you may be required to have your test performed in order to help your doctor (primary healthcare professionals) to get a better understanding of what is wrong and therefore be in the best possible position to help arrest the causative factor(s). Below is one of the scenario commonly encountered:

(1) Mr. Johnson have been complaining of fatigue, dizziness and lack of appetite coupled with persistent headache and decided to visit his doctor. 
What is the role of the medical laboratory scientist in assisting the physician provide the best possible care for this patient? 
Based on evidence base medicine, and given the multi-complexity of symptoms and signs, in modern practice, majority of the physicians will explore two major steps: firstly treat the symptoms for immediate relief and most importantly treat the causative factor (s) for a permanent solution if applicable. 

The physician can attend to the headache via prescription of Tylenol or applicable therapeutic intervention(s) after proper vital signs, and medical information have been obtained. Furthermore, for the appetite, multivitamins to help stimulate appetite might be prescribed too.
However the issues related to fatigue and dizziness cannot be simply addressed by symptomology alone, and therefore, at this junction it is normally important to find out the causative factor(s) related to the patient complained.

The medical laboratory scientist will get a laboratory test request from the primary healthcare professional to carry out diagnostic tests such as Complete Blood Count, Urinalysis, Blood glucose level and depending on the level of care some hormonal assays such as Thyroid Function Test, Liver Function Test, or comprehensive metabolic panel test, which will include cholesterol calcium level, electrolytes and urea and creatinine.
The outcome of the diagnostic test in most case will help the Primary healthcare professional to exclude and also include in the provisional diagnosis of Mr. Johnson.
In an exaggeratedly simple fashion; assuming Mr. Johnson has a low Red Blood Cell level, normal White Blood cell count and normal platelet count, and his other test are of no clinical significance, except for a  raised fasting blood glucose level.

The medical laboratory scientist based on his training appreciate that from a laboratory diagnostic perspective, he or she have helped the physician to narrow the multi complex provisional diagnosis to a case related to glucose imbalance (diabetes) and also anemia (low level of red blood cell). While further investigation may still be needed, at least Mr. Johnson may have additional therapeutic intervention by way of prescription of blood tonic and advise to reduce sugar intake for a given period of time and come back again for further evaluation! 

In a nutshell, the medical laboratory scientist assist the primary healthcare professionals and other medical professionals in the diagnosis, treatment and prevention of diseases. 

Research

The medical laboratory scientist role does not beginning or end in the hospital environment alone. We have research medical laboratory scientist that work in clinical pharmacology centers and other research related field, where they help in drug manufacturing, clinical trials which may be related to new drugs, existing one and medical devices. 
In this environment, medical laboratory scientist perform the role of quality control management, study protocol evaluation and adherence and most importantly interpretation of the study protocol as it relates to the performance of diagnostic testing during the study.

 A typical example may suffice here: A pharmaceutical company is interested in carrying out a clinical trial on an existing medication but for a new indication, and submitted the study protocol to the clinical research company for review. The role of the medical laboratory scientist working with the clinical department or unit will be to fashion out how to ensure compliance with regulatory laws, informed consent provision, determination of test menu, availability of diagnostic testing, outsourcing items in the test menu that may not be locally available within the facility and ensuring the overall quality control and quality assurance of the research from the laboratory perspective.

Today medication like Tylenol was made available in the market through FDA and other regulatory bodies approval as a result of a multidisciplinary interaction(s) between medical or clinical, laboratory and regulatory professionals, who through their various professional training where able to work on the study protocol from phase 1 through the final phases of the study leading to the approval of the medication.

Food Industry  
The medical laboratory scientist is an essential component in the maintenance, sustenance and prevention of food borne diseases, while ensuring the integrity of what we consume. Unknown to many, medical laboratory scientist are constantly engaged through their microbiological training in the testing of the food we eat before, during and in some cases after processing to ensure that our foods are not contaminated.
There are also situations where processed foods may be compromise, for instance as a result of bad storage! It is the role of the medical laboratory scientist working hand in hand with authorities to perform microbiology testing and ensure that these products are not contaminated and safe for consumption.

While the role of the medical laboratory scientist are numerous and beyond these three simple examples, for the sake of explanation, I have only targeted the medical or clinical, research and the food industry as a way of showing the vitality and potentials that await those who are interested in the field.

Additionally, in the United States of America, the medical laboratory scientist can use the profession as a stepping stone to pursue post-baccalaureate degree in medicine, pharmacy and nursing and other profession or career of choice.
The medical laboratory scientist is the custodian of medicine beyond the clinical stethoscope and help provide evidence base medicine in an environment that contemporary is filled with multi complexity in symptoms and signs, and that requires precise and tailor-made approve to diagnosis, treatment and prophylaxis, as opposed to mere generalized approach.

Thanks,

Peter Odeh BSC (HONS), MLS (ASCP), MT (AMT), CLS (NCA)
Medical Laboratory Scientist/ Medical Technologist/ Clinical Lab Scientist
CEO/Founder
ROPAN(NIG) LTD
P. O. Box 11912
Baltimore, MD 21207
Email: abodeofhaven1@gmail.com

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