Sir Muir Gray addresses Frontiers in Laboratory Medicine
“Manage knowledge as though it is money” was the advice that Sir Muir Gray offered pathologists and clinical laboratory scientists attending last week’s Frontiers in Laboratory Medicine (FiLM) conference that took place in Birmingham, England. He was explaining how 20th Century Medicine is evolving into 21st Century Medicine.
He observed that the development of clinical systems was one way that healthcare is transforming in the United Kingdom. For that reason, it is essential that pathology laboratories stake out a role in these clinical systems, since diseases will be diagnosed, treated, and managed in an integrated, systems-based manner.
Sir Gray stated that, as clinical services, pathology and laboratory medicine are well-positioned to make major value contributions to health, because of three attributes:
- One, clinical laboratories are generally the “most literate users” of information technology across the entire healthcare system.
- Two, clinical laboratories are “best organized” within healthcare, meaning that precision, efficiency, and purpose allow labs to respond and react to new technologies and new care delivery models
- Three, clinical laboratories are the most “altruistic” among medicine’s different specialties.
In crediting pathology laboratories as “altruistic,” Sir Gray was complimenting the profession while observing that pathology is a clinical service which is highly responsive to the needs of other medical professionals. He believes this is a strength and positions laboratory medicine to deliver high value to the entire healthcare system.
Value is a 21st Century concept that Sir Gray addressed in detail. “It is important to acknowledge that we are leaving behind the models of 20th Century Medicine,” he told the FiLM audience. “Vocabulary is one way to foster adoption of the concepts associated with 21st Century Medicine and the term ‘value’ is among the most important.
“In 20th Century Medicine, quality was the term most commonly used to describe the level of service,” explained Sir Gray. “For 21st Century Medicine, value will be more important than quality.” Gray believes value is the term which communicates the worth of a specific health service, because value carries within it the attributes of quality, while addressing the other attributes that convey all the value that meets the expectations and needs of a patient.
Sir Gray then presented a slide to the audience which defined a number of concepts that illustrate the evolution from 20th Century Medicine to 21st Century Medicine, as reproduced below:
| 20th Century Healthcare
||21st Century Healthcare|
|Doctor centered||Patient centered|
|Patient as passive complier||Patient as co-producer|
|Driven by finance||Driven by knowledge|
|High carbon||Low carbon|
|Focused on effectiveness||Focused on value, eliminating waste|
|Challenges met by growth||Challenges met by transformation|
For more than 35 years, Sir Muir Gray has been involved in public health in the United Kingdom. He did pioneering work to develop breast and cervical cancer screening programs. It was 2005 when he was knighted for his efforts in creating effective programs for fetal, maternal, and child screening. Another contribution was his role in the creation of the National Library for Health.
Sir Muir Gray’s comments about the transformation from 20th Century Medicine to 21st Century Medicine are a reminder to pathologists and clinical laboratory managers of the ongoing evolution that is under way in healthcare. Regardless of how pending bills may alter the American healthcare system, the concepts outlined above by Sir Muir Gray are powerful illustrations of the progress achieved to date, and it is not likely that healthcare reform legislation will sidetrack such trends as patient-centered care, and the use of systems and networks in the modern healthcare system.