When your doctor orders a blood or urine test, or takes a biopsy, all you usually know is that the sample goes to some mysterious place ("the lab" or "pathology") and either the same day or a few days later your doctor suddenly has a better idea of what is wrong with you and what to do about it.
The lab, however, is not really all that mysterious a place - blood, urine and other samples are handled in a way that is somewhat similar to what goes on in your doctor's office.
In fact, although you only meet them when you need very special types of laboratory procedures done, there are "laboratory doctors" (known as "laboratory medicine physicians" or "clinical pathologists") who supervise and directly carry-out these laboratory tests that are used to diagnose your illness and to determine what is the best treatment for your condition. The sample that gets sent to the lab represents (obviously) a "part of you" and that part needs to be examined the same way the doctor examines all of you in the office.Instead of listening to the blood with a stethoscope or looking at it after saying "ah", the laboratory doctor applies techniques to examine the specimen that range from the very "old" (looking at the components of the blood or tissue with a microscope) to the very new (analyzing complicated aspects of the DNA and proteins in the blood with "high-tech" machinery). Some parts of this analysis only require general supervision by the pathologist and are carried out by automated equipment; other parts require the continuous intervention by highly skilled technologists working under the supervision of the pathologist; still other aspects of the analysis require detailed consultation by the pathologist to determine how best to figure out what is causing your symptoms.
Although the clinical pathologist is most often the "doctor's doctor" who communicates directly with your primary physician and not directly to you, there are a number of circumstances where you might meet and be directly examined by the "laboratory medicine" physician.
Some procedures are frequently carried out by clinical pathologists, for example, bone marrow examinations and lymph node aspirations. In addition, all aspects of your care that involves blood transfusions and/or the manipulation of your blood (such as plasmapheresis and stem cell transplantation) are under the supervision of the laboratory medicine physician ("blood banker"). Therefore, at Yale, if you need to have your blood collected or manipulated or if you need a stem cell transplant, you will meet our physicians in the "pheresis clinic" (pheresis is the medical term for the manipulation of your blood).
Some of our physicians also have a regular office practice, especially in the area of hematology (which has a very great overlap with laboratory medicine) and you therefore may meet them in that setting.
Follow the link below for a listing of Yale Laboratory Medicine doctors, their backgrounds and specialties.
As for most aspects of your medical care, if you have Medicare, Medicaid, or a commercial "indemnity" insurance plan, you and your primary doctor have your choice as to where your laboratory testing is performed and what doctors are involved in interpreting that testing.
If you have a "managed care" insurance plan, then there may be some restrictions on who can perform your laboratory work; however, the vast majority of managed care plans in Connecticut include the Yale-New Haven Hospital laboratories and the Yale School of Medicine doctors as being "in plan."
Even if you have a plan that has designated a primary "exclusive" commercial laboratory for your laboratory work (for example, Quest Diagnostics or Smith-Kline), the exclusivity usually refers to the exclusion of other major commercial laboratories. Hospital laboratories, such as Yale-New Haven, are frequently permitted to perform your laboratory work.
To find out about lab tests, there are a number of books available that tell you what to expect and the usual reasons for a particular test being requested by your physician. One of these is co-edited by Yale Laboratory Medicine past Chair, Dr Peter Jatlow (The Patient's Guide to Medical Tests by Barry L. Zaret MD, Peter Jatlow MD and Lee D. Katz MD (Editors) 448 pages (November 1997) Houghton Mifflin Co; ISBN: 0395765366).
A useful web site for obtaining more information is at: Lab Tests OnLine.