Trends in clinical pathologists.

The Politics Underlying the Provision of and Changes in Pathology and Laboratory Services in the United States During the Roaring Twenties

“…7.8 However, by the early 20th century, there had been an exponential increase in available laboratory tests, and the increasing complexity of these tests precluded their being performed by the patient's clinician. 7,[9][10][11] This, along with an even larger increase in the number of hospitals in the United States, created a potential niche for clinical pathologists, 7,[12][13][14] as well as 2 opposing service models: hospital-based laboratories run by in-house clinical pathologists and commercial laboratories. The former tended to be smaller and less efficient, but provided more personal service, whereas the latter, benefiting from economy of scale, were often larger and more efficient with faster turnaround times.…”

“…10,18,40 EXPANDED VALUE OF LABORATORY TESTING DURING THE DECADE Having primarily addressed the politics of the decade, I would be remiss not to briefly mention that the menu of laboratory tests expanded vastly in the 1910s and 1920s and there was a legitimate need for clinical pathologists to recommend and interpret more esoteric tests. 10,[12][13][14] Furthermore, increased testing sophistication and sensitivity made it possible to perform tests with smaller and smaller volumes of blood-making old, useless tests suddenly practical. For instance, insulin was discovered in 1922 and blood glucose testing became a critical element in the treatment of diabetes during the Roaring Twenties; in fact, the discovery of insulin was actually made possible by advances in the ability to measure blood glucose.…”