Uggghhh.... Just when I had thought I'd thought of all the kinks, you go and throw this one into the mix!
In passing, a neuology resident told me that this was the trend in Puerto Rico to his understanding. I systematically ignored it as a typical "friend of a friend" story. Your question is the first that's put it on my career plate.
I know that Quest Laboratories is making significant headway in attempts to monopolize the pathology marketplace. In fact, after some recent acquisitions, I think an anti-monopoly suit was raised. Also Direct to Consumer (DTC) lab testing is becoming more popular for folks who want "above and beyond" diagnostics. So for folks whose evidence-based medicine practicing family docs won't order a PSA, they can go to their local CVS and have it done themselves for $100-200 bucks. These programs (arranged currently in pilot form between CVS and Quest) are starting to sprout up and may eventually have significant impact on the field of pathology.
My belief is that these changes can be "controlled" by our upcoming generation of pathologists. I think that we need to utilize technology to better serve our patients, be in positions of management and regulation in our labs, and be politically active when necessary. I don't think we need to succumb to being drones in nationwide lab chains (but this may become the trend if we let it.)
Mindy
