title: The practice of clinical pathology: a quantitative description of laboratory director activities at a large academic medical center.
abstract: OBJECTIVE
  The scope of activities performed by clinical laboratory directors is sometimes unfamiliar to other physicians or hospital administrators. Consequently, hospital leadership may undervalue the role and assume that many director level activities could be delegated to a professional manager. In this study, we sought to define the activities of academic laboratory directors, and to determine which activities require doctorate level medical or scientific expertise.
  
  
  METHODS
  We performed an audit of laboratory director activities at a large academic medical center by reviewing electronic calendars and other available records from the preceding 12 consecutive months. For episodic activities, the directors estimated the average number of hours devoted over the 1-year period.
  
  
  RESULTS
  On average, directors worked 54.9 hours per week and performed at least some service work 47.7 weeks per year. Administrative duties accounted for the greatest proportion of effort (47.1%), followed by clinical activities (33.1%) and academic activities (19.8%). Among administrative duties, those that required doctorate level medical or scientific expertise comprised 60.3% of the total administrative effort, whereas the remaining 39.7% (18.7% of total activity) could be performed by a professional manager..
  
  
  CONCLUSIONS
  Although the activities of clinical laboratory directors have been described elsewhere, this is the first study detailing the effort allocated to these various activities in quantitative terms. The study demonstrated that less than 20% of an academic laboratory director's effort involves administrative activities that could potentially be performed by a professional manager lacking doctorate level medical or scientific expertise.
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: John A
authors.initials: JA
authors.lastname: Branda
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Anand S
authors.initials: AS
authors.lastname: Dighe
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Walter
authors.initials: W
authors.lastname: Dzik
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Ferraro
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: James
authors.initials: J
authors.lastname: Flood
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Lee-Lewandrowski
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Robert
authors.initials: R
authors.lastname: Makar
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Murali
authors.initials: M
authors.lastname: Mandokolathur
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Rosenberg
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Susan
authors.initials: S
authors.lastname: Saidman
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sluss
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Aliyah R
authors.initials: AR
authors.lastname: Sohani
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Stowell
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Van Cott
authors.affiliation: From the Department of Pathology, Division of Laboratories and Molecular Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA. klewandrowski@partners.org.
authors.forename: Kent B
authors.initials: KB
authors.lastname: Lewandrowski
mesh_terms: D000046:Academic Medical Centers; D006769:Hospitals, General / Q000639:trends; D006801:Humans; D007755:Laboratories, Hospital / Q000639:trends; D010338:Pathology, Clinical; D008486:Physician Executives; D014937:Work; D000078329:Workforce
keywords: Clinical pathology; Diagnostic testing; Laboratory director; Laboratory medicine; Laboratory testing