Clinical pathology--déjà-vu? Clinical investigation in a specialised laboratory.

It is now more than 50 years since, in 1927, Sydney Campbell Dyke banded together the growing number of pathologists to form the British Pathologists' Association, which later became known as The Association of Clinical Pathologists. Dyke had a wide-ranging interest in medicine, unlike some of his successors, who have relinquished their clinical affiliations and have retired to the confines of their laboratories. Under the influence of men such as Dyke, clinical pathology expanded into a discipline in which one had to be an expert in a wide range of pathological subjects and to have knowledge not only of their laboratory aspects but also of their clinical applications. With the advancement of medical science, however, it is no longer possible to be an expert in all aspects of the discipline, and many have neglected the clinical aspects. Challenges are appearing on all sides. Within our laboratories some of the technical staffs believe that they should be in charge and that the medical pathologist should interest himself only in what are termed 'clinical matters'. This point of view has been propounded in the search for an elevation in status and the additional salary benefits that normally accompany it. The possible effects on the patient appear to have been overlooked. Some clinical colleagues have also encroached upon the pathologist by the establishment of small personal laboratories, particularly within university hospitals. In these laboratories, research projects quickly blossom into a routine service to the patient, resulting in the exclusion of the pathology laboratory and the clinical pathologist. Although the days of Dyke are over, it is essential