NEED FOR CLINICAL MICROBIOLOGISTS?

Dr.T.V.Rao MD
Many thought that need for learning practising Microbiology will vanish in 1980s. The community of
Microbiologists were grateful to onset of Pandemic of AIDS, associated with many opportunistic
infections, and woke up the world that the world of humanity lives at the mercy of Microbes, in spite
Modern medicine has led to dramatic changes in infectious diseases practice. Vaccination and
antibiotic therapy have benefited millions of persons. With few limitation with much access in the
developing world was at advantage with much resources, however, in Developing countries like
India with constrained resources now threaten our ability to adequately manage threats of
infectious diseases by placing clinical microbiology services and expertise distant from the patient
and their infectious diseases physician. The microbiology laboratory of the past featured primary
care doctors and hospital-based specialists periodically visiting the on-site laboratory to review
smear and culture results. Looking through the microscope or examining a culture plate solidified
impressions that were carried to the bedside and prominently used in therapeutic decision making.
It was told for more than two decades by those with vision to human progress that Microbiologists
should be out of their chair from comfort zones to linking the laboratories with the hospital services,
Today India needs much changes in thinking the role of Microbiologists in many teaching hospital to
be redefined emerging challenges conversation among medical microbiologists is needed to focus
efforts on defining, standardizing and improving our performance as clinical microbiology laboratory
directors Current changes mainly consist of moving from a hospital-based service with close
interaction among interested physicians, laboratory professionals, and other staff involved with
patient care hospital-wide to a centralized laboratory service that is distant from many hospital sites
and thus renders frequent, direct interaction impossible. Now with efforts of Medical Council of
India many teaching hospitals are going in the establishment of centralised diagnostic laboratories.
Yet many of our Microbiologists have to learn the concept of effective communication with the
clinicians, Because Effective communication is one of the most important characteristics of a
microbiology laboratory, wherever it is located. To be effective, the opportunity for dialogue
between health care providers and laboratory personnel must be readily accessible, if not
immediately available. Provision must be adequate for bidirectional interaction, because the
information provided is nearly always qualitative and interpretive. However I have realised many
decades back if we as Professor or senior consultants have to move from comfortable arm chair job
to war zone in the hospital where there is true fight of microbes and patients is going in the wards or
critical care areas,

TO BE A CLINICAL MICROBIOLOGIST Needs a greater interaction with clinicians and

nurses who are in face with the patient care, I realise it is a real time learning , To be effective clinical
microbiologist , the opportunity for dialogue between health care providers and laboratory
personnel must be readily accessible, if not immediately available. Provision must be adequate for
bidirectional interaction, because the information provided is nearly always qualitative and
interpretive. Face-to-face meetings that occur either at scheduled times or on an ad hoc basis
whenever necessary, as dictated by the patient's needs, best accomplish this goal. To make the
matters work for the advantage of health care system, there should be knowledged Microbiologists
and listening clinicians to appreciate the scientific facts on infectious diseases important
contributions made by microbiology to clinical research, with direct implications for patient care,
include studies of optimal conditions for, and performance of, a wide variety of microbiological
diagnostic and therapeutic tests. Without rigorous research by credible laboratories, development of

improved diagnostic methods is severely retarded, if performed at all. Furthermore, pharmaceutical

companies currently depend upon the academic microbiology laboratory to provide diagnostic
testing for clinical trials of new antimicrobial drugs. Successful detection and interpretation of results
clearly require adequate staffing with specially trained medical technologists and supervision by
laboratory directors who have received training in a clinical and/or medical microbiology program
that qualifies them for certification, as happening with NABL and NABH accreditation in our country,
thus promoting good patient care outcomes that save money, as a society, our goal is to achieve
excellence in patient care, diagnosis and treatment that are affordable, and high quality as a
measurable outcome. Maintaining high-quality clinical microbiology laboratories supports all these
aspirations, The scene today is one of near silence and no conversations, featuring only computer
screens and keyboards in outpatient offices, clinic examination rooms, hospital intensive care units,
and patient bedsides where the physician, physician's assistant, nurse practitioner, or other
caregiver merely reads computerized reports and then type notes and orders, with least interaction
with a competent Medical or Clinical Microbiologist

WE NEED THE CHANGES IN TRAINING OF OUR MD GRADUATES The future does look
different. Changing POST GRADUATE training and contributions to match the new needs of the
profession must be combined with a renewed energy by individuals and professional organizations
to underscore the value of clinical microbiology laboratory PERSONAL to fellow professionals, I wish
future may change if the MD students in Microbiology are spending at least 6 moths in the critical
care areas and septic patients, it will make them to realise the importance of human life than just
laboratory supervisors and resting teachers with growing conflicts in the departments with idleness
and lack of accountability to life.

TEACHERS SHOULD CHANGE TO FUTURE Many times I am sceptical about the role of many
teachers who wish to be safe in a system without contribution however when we really fight for
change matter may have much repercussions on us as many still believe living with ignorance is a
bliss however for me it is truly dangerous for institutes which wish to progress,

NEVER FORGET IF THE EFFECTIVE CLINICAL MICROBIOLOGY IS NOT PRACTISED THE

HUMAN LIFE FACES THE CHALLENGES OF IGNORANCE OFTEN THEY ARE MAN MADE
FACTORS,

WE NEED A CHANGE OF WORK CULTURE HOPE WE WAIT FOR A CHANGE?

References and adoptions - Role of Clinical Microbiology Laboratories in the Management and
Control of Infectious Diseases and the Delivery of Health Care L. Barth Reller, Section Editor et al
Clinical infectious diseases Wed, 14 Feb 2001 in Clinical Infectious Diseases
2 What Will the Role of the Clinical Microbiology Laboratory Director Be in 2015 Richard B. Thomson
Jr.1,* and Gary V. Doern2 . Clin. Microbial. September 2011 vol. 49 no. 9 Supplement S68-S71
Dr.T.V.Rao MD Professor of Microbiology Freelance writer