The changing role of the clinical laboratory scientist: coming out of the basement.

The position of clinical chemistry within the discipline of laboratory medicine is firmly established. As a result, pathologists, chemists, and scientists have been attracted to an emerging field full of promise and expectations. For most, the expectations of a rewarding career and growth of the discipline have been met. However, in a climate where factors such as "capitation" and "managed care" influence every facet of healthcare, many are reviewing their expectations and wondering whether the 21st century will bring the same promise enjoyed by the pioneers in the 20th century. In the future, laboratory scientists must align their expectations to the demands for new technologies, medical practices, and healthcare systems that will require justification for all activities, expense, and personnel. To succeed in this new environment, the clinical chemist will need excellent managerial skills, an understanding of how to articulate the benefits of technologies and laboratory tests, and a willingness to embark on a career of unceasing education.