Pathology labs across the country could face a massive shortage of “competent” people to sign your lab report, cautions Girdhar Gyani, Director General with the Association of Healthcare Providers (India).

His concern arises from a recent Supreme Court directive that allows only medical practitioners with a postgraduate 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 at the massive shortages that loom over the three-lakh odd pathology labs across the country. “Patient safety can be hit,” he said, adding that he has raised the issue with the Health Ministry.

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 was changed when the MCI in 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 the Supreme Court had last month endorsed this view, Gyani explained.

“No less competent “

Responding to whether possible malpractice or quality concerns may have prompted such action, Gyani said, “those with an MSc and PhD qualification are no less competent than any doctor as they already had an analytical bent of mind and are part of the teaching staff.” Besides, he pointed out, they were not “seeing patients or treating them”.

Dr Gyani was earlier Chief Executive of NABH (National Accreditation Board for Hospitals and Healthcare Providers) and General Secretary of the Quality Council of India.

Citing the international norm ISO 15189, he said that those qualified in MSc/PhD in BioChemistry and Microbiology were competent to countersign medical reports. The problem arises from turf-wars between pathologists and technicians, he added. And with the SC directing as it has, NABH will be forced to deal with pathlabs not fitting in with their direction.

The Indian Medical Association’s view is that basic lab reports can be counter signed only by a registered medical practitioner and advanced lab reports by a registered medical practitioner with a post graduate qualification in pathology.

“Lab reports needs 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,” IMA said.

Following the Supreme Court verdict, the total number of authorised signatories available to the labs will drop dramatically, Gyani said, pointing to the shortage of doctors that already exists across the country. Given the number mismatch between the labs and the available qualified doctors, they will be overworked, he said.

“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 added.