AJCP / SPECIAL REPORT Laboratory Medicine in the 21st Century

At the end of the 19th century, medical problem solving relied almost entirely on history taking and physical examina-tion. The enormous advances in science and technology that have characterized the 20th century have so transformed the practice of clinical medicine that now, as we approach the next millennium, history taking and physical examination have increasingly given way to a practice of medicine domi-nated by the use of medical technology—in particular, labo-ratory testing. There is every reason to believe that this trend will continue into the 21st century. Moreover, it will continue against a background of continuing advances in information technology and computer-based electronic communica-tions—advances that could revolutionize the provision of medical care through online dialogue among patients, data-bases, clinicians, pathologists, and other laboratory profes-sionals. These changes in the provision of health care are likely to have profound effects on the practice of laboratory medicine—effects that will be determined by the competing demands of cost containment, assurance of quality, and finan-cial support of education and research