Pathology labs across the country may face a shortage of “competent” people to sign lab reports, cautions Girdhar Gyani, Director-General, Association of Healthcare Providers (India).

His concern stems from a recent Supreme Court directive that allows only medical practitioners with a post-graduate qualification in pathology to countersign a medical lab report. A view held by the Medical Council of India (MCI).

In one stroke, the number of people who can sign a lab report reduces from 36,000 to 5,500, Gyani told BusinessLine , concerned over the massive shortage that looms over the 3-lakh pathology labs across the country. “Patient safety can be hit,” he said. Gyani has raised the issue with the Health Minister and Secretary.

Earlier, lab reports were reviewed and signed by an MD Pathology, MD Microbiology, MD Biochemistry, MSc or PhD in Microbiology and Bio-Chemistry. But this changed when the MCI, in its June 2017, debarred those having an MSc or /PhD in Biochemistry and Microbiology from signing test reports. The MCI order was challenged in the courts and last month the Supreme Court endorsed the MCI view, Gyani explained.

On whether malpractice or quality concerns prompted such action, Gyani responds that a professional with an MSc or PhD qualification is “no less competent than any doctor” as they already had an analytical bent of mind and were part of the teaching staff. Besides, he adds, they do not “see” or treat patients.

Dr Gyani was earlier Chief Executive of NABH (National Accreditation Board for Hospitals and Healthcare Providers) and General-Secretary, Quality Council of India. The real problem, Gyani observes, arises from turf-wars between pathologists and technicians. And with the apex court directive, the NABH will be forced to deal with pathlabs not fitting this definition.

Om Manchanda, Chief Executive with Dr Lal Pathlabs, the only listed company of its kind, says they are not operationally affected as their satellite labs are run by those with an MD Pathology qualification, while the central lab had registered medical doctors and PhDs under one roof. Echoing similar sentiments, Metropolis Managing Director Ameera Shah says they already abide by the ruling. “If the Supreme Court has made this decision, it must be for a good reason. However, in India we do need to confront the other issue of currently not having enough qualified MDs to sign reports,”she adds.

Falling short

Agreeing with the observation on shortages, the Indian Medical Association’s Dr KK Aggarwal says that their view was that a basic lab report could be counter-signed by a registered medical practitioner, only advanced lab reports need a registered medical practitioner with a post graduate qualification in pathology. “Lab reports need interpretation with clinical findings and previous reports and these reports are often a decision maker in clinical treatment and hence require signature of atleast an MBBS doctor. Any report without an interpretation may be incomplete,” he said.

But Gyani worries about the drop in authorised signatories for lab reports at a time when there already exists a shortfall of doctors across the country. Qualified doctors will be overworked, given the number mismatch between the labs and the available doctors, he says.

“These professionals will be pushed to become visiting signatory authorities covering many cities. Pathologists may begin lending electronic signatures from one central office to hundreds of test reports. All this will hamper the authenticity of test reports, which are the sole basis for physicians to prescribe treatment,” and this will impact semi-urban and rural areas the most, he says.