The role of pathologists in the implementation of Medical laboratory utilization management

Authorities responsible for policy making in Health Care System are committed to manage laboratory system and ensure that appropriate, qualified and timely laboratory services are provided for all community members. With respect to providing appropriate laboratory services, it is essential to include Medical laboratory utilization Management in health care macro policies.Laboratory utilization management is an integral part of Ministry of Health (MoH) operational plan since 2017.One of the major concerns in implementing the utilization management, is who will take the overall leadership for the program. Clinicians might be in the best position to take the lead, as they have the medical knowledge to make judgments about what is in the best interests of the patients. However, many references believe that pathologists are the most logical group to play a leadership role. Clinicians are often consumed with their clinical responsibilities and sometimes have little motives for doing this kind of activities. On the other hand, pathologists have experience directing complex organizations i.e. laboratories and utilization management is part of their expected professional duties. Moreover, pathologists understand the cost and reimbursement process for laboratory tests, and have access to test volumes, trends, and ordering patterns through the laboratory information system. So, pathologists by virtue of their role as laboratory directors are in a much better position to lead the utilization management program than most of the clinicians, particularly those practicing in narrow specialties. Pathologists can serve as the hub of a wheel connecting to physicians with different specialties and coordinating the overall activities. Therefore, in the operational plan of the MoH, pathologists are assigned as focal points of the medical universities, and are responsible for coordinating the implementation of the program in their university. After passing about 1 year from the beginning of the operational plan, in the last gathering of the universities’ focal points, they were asked to fill out a questionnaire. The results revealed that more than 90% of them strongly believed in necessity of implementing the program However, they stated that the program has not yet been effectively established in universities.It could be concluded that the effectiveness of this program depends on many other factors, especially collaboration of the clinicians and availability of appropriate software infrastructure.