Doctors Say Clinical Labs Are Indispensable, but System Pressures Threaten Collaboration
Nearly all doctors call lab testing essential, but shortages and patient pressures are putting the system to the test.
Physicians across the United States certainly recognize the indispensable role of clinical laboratory testing in patient care, but growing workforce shortages, financial pressures, and rising patient demands are straining the system, according to a new survey conducted by YouGov on behalf of Siemens Healthineers.
The survey was released on July 29, during the Association for Diagnostics & Laboratory Medicine (ADLM) conference in Chicago.
The Dark Daily recently covered how findings at ADLM showed digital pathology trends are being slowly adopted in the US but how there’s a larger movement to connect patient care more directly.
The survey of 408 physicians, along with a parallel poll of 1,000 patients, reveals both how deeply doctors depend on laboratory professionals and how external pressures are reshaping testing decisions.
“Ninety-nine percent of physicians agree clinical lab testing is an integral part of the healthcare system,” the report states. Nearly all respondents said lab results are vital in informing treatment choices, with 98% noting they had modified a diagnosis or care plan based on test outcomes. As one physician put it, lab tests “help determine my actions” by providing crucial clarity in uncertain cases.
Doctors also reported that laboratory insights streamline the use of other healthcare resources. “Together, we help the health system and avoid unnecessary patient interventions,” one physician said, noting how test results often reduce the need for additional imaging or biopsies. In fact, 100% of surveyed physicians agreed that lab data helps them use other healthcare tools more effectively.
The Growing Strain on Labs
Despite reliance on labs, the collaboration doctors depend on is increasingly at risk. Clinical laboratory professionals manage more than 80,000 different tests across US facilities and generate roughly 14 billion results annually. Yet the workforce supporting this output is shrinking.
“When labs are short-staffed, it has a downstream effect on patient care,” 96% of doctors agreed. Another 94% expressed concern about healthcare staffing shortages more broadly. The problem is particularly acute in laboratories, where the number of training programs has dropped below 250 nationwide, leaving only about one lab scientist per 1,000 Americans.
Financial pressures are compounding the workforce issue. Though lab services account for only 4% of hospital costs, they are frequently targeted for cost-cutting. Consolidation and outsourcing have moved testing away from local facilities and toward centralized “dark labs,” largely operated by automation. While these high-tech labs maintain throughput, physicians caution that automation cannot replace collaboration. “In the age of automation, the human collaboration physicians depend on still counts,” the report warns.
Patient Demands Reshape Testing
Physicians are also feeling pressure from patients, many of whom arrive armed with information—or misinformation—from the internet. This rising “patient agency,” defined as the ability to influence healthcare decisions, is reshaping physician-patient interactions.
“Patient requests have forced me to weigh patient satisfaction against clinical judgment,” one physician admitted. Survey data shows 84% of patients expect their doctors to order requested tests, while 76% of physicians acknowledged ordering labs simply to satisfy those requests.
Zobair Younossi, MD, MPH, chairman, The Global NASH/MASH Council, said, “As a hepatologist dedicated to enhancing liver disease care, I believe that advances in laboratory testing are enabling us to ‘move the needle’ from liver biopsy toward blood-based biomarkers, allowing for earlier intervention through less invasive methods. For this shift to be successful, collaboration between clinicians and laboratory professionals is essential.” (Photo credit: MASH Alliance)
At the same time, 90% of patients said they trusted their doctor’s recommendation if the physician advised against unnecessary tests. Still, the survey underscores tension: while exploratory testing may placate patients, it can also create unnecessary costs and confusion. “Laboratory testing may be somewhat mitigating, though it can add unnecessary volume and expense for already overburdened clinical laboratories,” the report cautions.
The Hidden Role of Cost and Bureaucracy
Physicians also report external bureaucratic and financial pressures influencing test orders. About 32% said they had faced directives to reduce testing, while only 37% had visibility into the cost of lab tests they ordered. That number dropped further when asked about insurance coverage.
“Inadequate healthcare coverage may prevent patients from getting the appropriate level of laboratory testing,” the report notes. Among doctors who do know test costs, 60% admitted delaying orders due to expense concerns. From the patient side, 29% of respondents reported unpaid medical bills, with more than half saying their debt included lab testing fees.
Physicians are caught between avoiding unnecessary spending and protecting themselves from malpractice risk. Nearly 70% cited fear of being sued for misdiagnosis as a top concern, and 92% said they consider whether lab testing might reduce that risk. As one doctor put it, “Errors that negatively impact a patient’s care weigh heavy on my conscience and affect my mental health.”
A Call for Stronger Collaboration
Despite these pressures, doctors remain clear on their priorities. “Ninety-five percent agree that ordering tests to validate a patient’s care plan is their priority over conserving resources,” the report found. To achieve that, physicians want stronger ties with clinical lab professionals.
More than half—55%—said they heavily rely on lab experts to confirm which tests are most relevant, while 96% said they welcomed feedback from laboratory colleagues to improve ordering practices. “Physicians say clinical laboratory professionals are essential partners in delivering high-quality patient care, but a shrinking laboratory workforce may threaten the collaboration doctors rely on for clinical clarity,” the report concludes.
The Future of the Lab
Looking ahead, the report raises the question of whether the rise of automation-heavy dark labs will be a temporary solution or a permanent shift. For many doctors, the fear is losing the human expertise that helps interpret increasingly complex test menus.
“What physicians want are clinical partners and greater access to skilled professionals whose clinical insights help inform their patient care decisions,” the report states.
Without reinvestment in labs and workforce development, patients may face longer wait times, higher costs, and reduced trust in the system.
Ultimately, both doctors and patients recognize the centrality of the lab. The challenge now, as the survey shows, is ensuring those professionals are supported. “Recognizing laboratory professionals as collaborative clinical partners, and resourcing clinical labs as essential infrastructure rather than cost centers, is vital to safeguarding the important clinical support physicians rely on,” Siemens Healthineers concluded.
—Janette Wider
