The Alteration of Physicians' Orders by Nonphysicians

1988 
To the Editor.— The article "Alteration of Physicians' Orders by Nonphysicians" 1 addresses a well-documented problem 2,3 that wastes limited health care resources and threatens patient care: 4,5 inappropriate use of clinical laboratory services. As described by Finn et al, 1 the intervention of clinical laboratory scientists (medical technologists) is effective in improving the percentage of appropriate test orders, and we agree. However, we disagree with the authors' conclusions that interventions by technically knowledgeable laboratory scientists constitute "errors in the transmission of information" and "[have] the potential to delay diagnosis, and increase unnecessary testing." On the contrary, the test-ordering process and the clinician-laboratory interface can be improved by these kinds of actions as well as by other strategies, such as clinical laboratory scientists' use of laboratory-triggered algorithms, which have the potential to reduce the time and cost of rendering diagnosis. 6,7 Generally, such interventions now occur on an informed but
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