Defining the Practice, off tlie Medical Tectinology// Clinicalj laboratory Science, Profession, CG INTENDED LEARNING OUTCOMES At the end of the lesson, the students should be able to: 1. discuss the practice of medical technology focusing on the nature of the profession in relation to the detection and diagnosis of diseases; and 2, differentiate medical technologists from other laboratory personnel such as laboratory technicians, pathologists, and the like.7 Defining the Practice of the Medical Technology/Clinical Laboratory Science Profession 19) 6 PRE-TEST Name: mer i _Score: pent-of Section: Date: = Instructions: Choose the letter that corresponds to the correct answer and write it on the blank provided. 1. It is also known as Republic Act a. Medical Technology Act of 1969 b. Medical Technology Act of 1967 ©. Blood Banking Law d. Clinical Laboratory Act He or she is engaged in the work of medical technology. a. Phlebotomist ©. Pathologist, b. Medical technologist d. Medical technician 3. He or she is engaged solely in the collection of blood. a. Phlebotomist c. Pathologist b. Medical technologist d. Medical technician 4. Itis the year when R.A. 5527 was approved. a. 1967 1969 b. 1968 a. 1970 He or she is a graduate of medical technology with a board rating lower than 74.9%. a. Phlebotomist c. Pathologist b. Medical technologist d. Medical technicianDefining the Practice of the Medical Technology/Clinical Laboratory Seience Profession Nature of Medical Technology The medical technology profession continues to develop over the years. Nowadays, the science of medical technology has evolved tremendously because of the development of modern equipment and new procedures aimed at helping in the diagnosis and treatment of diseases. In understanding the nature of medical technology, it is important to understand the connection between science and technology. Science is primarily concerned with the study of the natural world and the interrelationship among the biological, psychological, and even the social world. Disciplines in the sciences constantly evolve to adapt to the changing needs of human beings. Many principles of medical technology are highly dependent on developments in the scientific disciplines and areas such as chemistry, electronics, optics and mechanics, among others, in order to develop a utilizable biotechnology that will aid in the diagnosis of diseases. Technology, on the other hand, is the application of science in ways that are considered beneficial to society. Technology can be defined in three ways: first, as a physical artefact, machine, or instrument; second, as an activity or a means to accomplish a goal; and third, as knowledge (Howell, 1996). Rogers (1983) asserts that “technology is a design for instrumental action that reduces the uncertainty in the cause-effect relationships involved in achieving a desired outcome.” Technology also consists of physical elements such as equipment, materials, or products, and intangible elements, such as knowledge, skills, procedures, principles, or information base required to successfully implement the technology. To sum up, technology is an avenue for humans to alter or modify the environment in order to extend their abilities to create, invent, discover, or innovate to make the world a better place to live in. Medical technology is designed to improve the detection, diagnosis, treatment, and monitoring of diseases. As such, it has linkages with many other disciplines for specific diagnostic or therapeutic purposes (Evans et al., 2003). Its nature is contextual, interdisciplinary, interdependent, and systems-based. It is dependent on the application, purpose, environment, and setting in which it is applied. Clinical laboratory testing plays a crucial role in the detection, diagnosis, and treatment of diseases. Clinical laboratory scientists who perform most of these laboratory tests, are involved in the examination and analysis of body fluids, tissues, and cells. Laboratory scientists usually look for the presence of bacteria, parasites, and other microorganisms in the body. They analyze the chemical contents of fluids, match blood for transfusions, and test for drug levels in the blood to show a patient's response to a specific treatment. They also prepare specimens for examination, to count cells, and look for abnormal cells in the blood and other body fluids. They use microscopes, cell counters, and other sophisticated laboratory equipment. They also ‘use automated equipment and computerized instruments capable of performing a number of tests simultaneously. After testing and examining a specimen, laboratory scientists analyze the results and relay them to physicians. 222 Principles of Medical Laboratory Science 1 With increasing automation and innovations in. computer ‘technology, the work of technologists and technicians has become less hands-on and more analytical. The complexity of tests performed, the level of judgment needed, and the amount of responsibility assumed by the laboratory personnel are grounded on extensive education and experience. Medical Technology Practice Defined In the Philippines the medical technology profession and its practice is governed and defined in section two (2) of R.A. 5527, also known as the Medical Technology Act of 1969. Section 2 of the Republic Act, as amended by R.A. 6132, P.D. 498, and P.D. 1534, defines the practice of medical technology: Section 2. a. Practice of Medical Technology ~ A person shall be deemed to be in the practice of medical technology within the meaning of this Act, who shall fora fee, salary or other compensation or reward paid or given directly or indirectly through another, renders any of the following professional services for the purpose of aiding the physician in the diagnosis, study and treatment of diseases and in the promotion of health in general: 1. Examination of tissues, secretions and excretions of the human body and body fluids by various electronic, chemical, microscopic, bacteriologic, hematologic, serologic, immunologic, nuclear, and other laboratory procedures and techniques either manual or automated; 2. Blood banking procedures and techniques; Parasitologic, mycologic and microbiologic procedures and techniques; 4, Histopathologic and cytotechnology; provided that nothing in this paragraph shall inhibit a duly registered medical laboratory technician from performing histopathologic techniques and procedures; Clinical research involving patients or human beings requiring the use of and/or application of medical technology knowledge and procedures 6. Preparations and standardization of reagents, standards, stains and other provided stich reagents, standards, stains and others are exclusively for the use of their laboratory 7. Clinical laboratory quality control; 8. Collection and preservation of specimens: Provided, That any person who has passed the corresponding board examination for the practice of a profession already regulated by existing law, shall not be subject to the provisions of the last four preceding paragraphs if the performance of such acts or services is merely incidental to his profession (Section 2, a). All aforementioned are commonly observed in a clinical laboratory (Cardona et al., 2015). However, some of these may not be exclusive to medical technologists. Microbiologists,Defining the Practice of the Medical Technology/Clinical Laboratory Science Protession biologists, chemists, and even sanitary engineers may be involved in some activities usually ne by medical technologists. A medical technologist must first become licensed before he hhe is permitted to practice the profession. Practicing as a medical technologist without a icense is punishable by law. It should also be considered that the medical technology practice wuld be bound by the accepted pledge of oath in accordance with the Code of Ethics of dical Technology which states that the Medical Technology professional should accept the responsibilities inherent to being a professional and shall not engage in any illegal activities. following are the original and revised versions of the medical technology code of ethics. Original version (by Dr. Nardito Moraleta) Upon entering into the practice of medical technology let it be known that: accept the responsibilities associated with my duties. I shalll uphold the ideals of my profession. Lam aware that since the physician relies upon my work in the diagnosis and treatment of diseases, any error may affect the health or even the life of the patient. Every procedure and observation therefore must be carried out with absolute reliability, accuracy, fairness, and honesty. Tam aware of the need for mutual understanding and cooperation among my fellow workers in the medical and paramedical field in the pursuance of a worthy cause Ishall strive to preserve the integ whom we expect the same. ity of myself and the professionals from ty of myse! I shall strive to develop necessary virtues needed in my work and shall place my service above any other considerations. I shall restrict my phrases, criticisms, values, and opinions, within constructive limits and I shall not use the knowledge I know as a tool for my selfish personal en Trealize that the knowledge I acquired about any individual in the course of my work must be treated as confidential, And since the physician has the ultimate responsibility in the diag: 1 treatment, my result must be known only by him. I shall neither make diagnosis nor interpretations other than this in the report made by me nor shall I advice the physician or others on how to treat dise osis ar I shall believe in full and equal opportunities in the pursuance of our ideals within the context of the principles of human rights. To these principles, I hereby subscribe, promising to conduct myself at all times in a manner appropriate to the dignity of my profession. 2324 Principles of Medical Laboratory Science 1 Revised version (by Prof. Rodolfo Rabor) As I enter into the practice of Medical Technology, I shall accept the responsibilities inherent to being a professional; I shall uphold the law and shall not engage in illegal work nor cooperate with anyone so engaged; I shall avoid associating or being identified with any enterprise of questionable character; I shall work and act in a strict spirit of fairness to employer, clients, contractors, employees and in a spirit of personal helpfulness and fraternity toward other members of the profession; I shall use only honorable means of competition for professional employment or services and shall refrain from unfairly injuring, directly or indirectly, the professional reputation, projects or business of a fellow medical technologist; I shall accept employment from more than one employer only when there is no conflict of interest; I shall perform professional work in a manner that merits full confidence and trust carried out with absolute reliability, accuracy, fairness, and honesty; I shall review the professional work of other medical technologists, when requested, fairly and in confidence whether they are subordinates or employees, authors of proposals for grants or contracts, authors of technical papers or other publications or involved in litigation; I shall advance the profession by exchanging general information and experience with fellow medical technologists and other professionals and by contributing to the work of professional organizations; I shall restrict my praises, criticisms, views, and opinions within constructive limits and shall not use the knowledge I know for selfish ends; I shall treat any information I acquired about individuals in the course of my work as strictly confidential, and may be divulged only to authorized persons or entities or with consent of the individual when necessary; I shall report any infractions of these principles of professional conduct to the authorities responsible for the enforcement of applicable laws or regulations, or to the Ethics Committee of the Philippine Association of Medical Technologists as may be appropriate To these principles, I hereby subscribe and pledge to conduct myself at all times in a manner befitting the dignity of my prcDefining the Practice of the Medical Technology/Clini Laboratory Science Profession Roles and Responsibilities of Medical Technology Professionals Medical ‘Technology is indeed a rapidly advancing discipline and profession. The role of medical technology professionals in the diagnosis and treatment of diseases is very crucial in health care practice. In the Philippines, R.A. 5527 or the Medical Technology Act of 1969, defines the scope of work of the different medical technology professionals. There is no doubt that the role of the medical technologist is to collaborate with other health care practitioners to provide humane and dignified health service. The following are the tasks of medical technology professionals in the practice of laboratory science. Perform Clinical Laboratory Testing st basic to the most graduate of Bachelor of Science in Medical Technology/Medical A medical technologist must be capable of performing the m advanced laboratory tests. Laboratory Science is expected to show competency in performing routine laboratory tests including urinalysis and stool examination. He or she should be capable of performing hematologic, microbiologic, serologic, chemical, and other procedures in the different areas of laboratory science. In tur, it is expected that the clinical laboratory will be equipped with the resources necessary for performing such procedures or any kind of laboratory testing. Perform Special Procedures Medical technologists are also expected to perform special procedures in diagnosing diseases. These may include the operation of advanced diagnostic equipment. Special procedures can also include molecular and nuclear diagnostics. Ensure Accuracy and Precision of Results In performing different procedures to diagnose diseases, a medical technologist should always be conscious of the accuracy and precision of both the testing process and its results. Accuracy and precision impacts the interpretation of results by the physician to provide proper medication in the treatment of diseases, Be Honest in Practice A practicing medical technologist, like any other professional, is expected to be honest in the practice of his or her work. It is important that a medical technologist values honesty, particularly in conveying or reporting the results of any laboratory procedure. He or she should act according to the Medical Technology profession's Code of Ethics and his or her pledged oath of practice. A medical technologist must be honest at all times in the conduct of test procedures to come up with accurate and precise results. 2526 Principles of Medical Laboratory Science Ensure Timely Delivery of Results In collaborating with other health care practitioners, a medical technologist must be aware of the urgency of delivering results on time especially in cases that require urgent treatment. There are times when physicians will request laboratory tests which require immediate action. One should take notations on “STAT” or even observe the source of the (e.g. from the emergency room [ER] or operating room [OR]). It is important a medical technologist to be alert to fully address the needs of the patient. Since some laboratory procedures are time bound, it is important that a medical technologist is able to perform the duties required of him or her, as soon as possible. Demonstrate Professionalism A medical technologist must be able to perform his or her functions according to the professional Code of Ethics for medical technology professionals. He or she should be aware of the laws and regulations governing the practice of medical technology and should not exploit its function beyond its boundaries. In the Philippines, the practice of medical technology profession is governed by R.A. Medical Technology Act of 1969. Other governing regulations are supplemented by the Clinical Laboratory Act of 1966 (R.A. 4688) and the Blood Banking Acts of 1956 (R.A. 1517) and 1995 (R.A. 7719). National organizations such as the Philippine Association of Medical Technologists, Inc. (PAMET) and the Philippine Association of Schools of Medical Technology and Public Health, Inc. (ASMETH) also have their own constitutions and by-laws in accordance with the governing laws and code of ethics. Uphold Confidentiality Ensuring confidentiality of patient's information is one of the core duties within the medical practice (De Bord et al.). Confidentiality requires health care providers to keep a patient's personal health information private unless the patient consents to release the information. Patient records are expected to be kept in confidence by the medical technologist It is expected that these records containing very important information are protected and made available only when necessary. A medical technologist must be aware at all times of the value of confidentiality and the entirety of the ethical codes of their profession. Collaborate with Other Health Care Professionals medical technology professional is required to collaborate with other health care titioners in order to build a.well-functioning team. Most often, projects fail because people fail to cooperate with others. Collaboration is the act of working together in order to achieve a desired outcome. Success in the health care setting is achieved not because of the availability of highly sophisticated hospital or laboratory equipment, but because of teamwork A highly-trained physician will only be able to efficiently treat his or her patient if laboratory preDefining the Practice of the Med Te ology/Clinical Laboratory Science Profession 1g Monitoring, drug prescription and dosage, and more are properly rendered and ministered by other health care professionals. These protocols cannot be done by the sician alone. Having one non-collaborative and incompetent member in the team alone result in potentially dire repercussions. Conduct Research update cantly .chnologists must also be engaged in research activities t neir skills. Research work, 1 or descriptive can contribute signif o the discovery of new knowledge in the field of medical technology and in assessing and evisiting already known ones. It can greatly help in the further development of the field and may be used as future reference for patient care. Practicing medical whether experim Involvement in Health Promotion Programs Medical technologists should not be confined only to the four corners of their clinical aboratories. Medical technology is a multi-disciplinary field which consistently ventures into ther areas of health care including health promotion. A medical technology professional st be actively involved in reaching out to the community. There are many ways by which the medical technology profession can help improve the lives of people. Other health care professionals such as nurses and physicians are easily seen in community outreach programs because of the nature of their professions. Medical technologists, as valuable health car professionals, are also expected to do the same. The following are some ways that medical technology professionals can help the community 1. Cooperate with other health care professionals in healt! such as promoting the ideal attitudes on hygiene, community sanitation, waste segregation, and disease prevention h promotion campaigns 2, Implement pre-planned programs of health promotion campaigns. 3. Offer free laboratory testing such as blood typing, urinalysis, fecalysis, blood sugar 1g, and other tests beneficial to the entire community: testing, cholesterol testi 4. Collaborate with other health care professionals once diagnoses are done. Defining the Practice of Other Laboratory Personnel ‘The following is a list of other valuable laboratory personnel with various roles in the health care delivery system, specifically in the area of laboratory medicine. It is important to note that medical technologists worl provide accurate and precise laboratory results. The different roles of different laboratory personnel are interconnected. It is important that all should work in harmony in order to provide the best patient care. closely with these laboratory personnel in order to 21Principles of Medical Laboratory Science 1 Pathologist As defined in R.A, 5527: A pathologist is a duly registered physician who is specially trained in methods of laboratory medicine, or the gross and microscopic study and interpretation of tissues, secretions and excretions of the human body and its functions in order to diagnose disease, follow its course, determine the effectivity of treatment, ascertain cause of death, and advance medicine by means of research (Section 2, b.) A pathologist is always considered to head a clinical laboratory and monitor all laboratory Tesults. A laboratory result without the signature of a pathologist may not be éonsidered valid. Medical Laboratory Technicians ‘As defined in R.A. 5527: A medical laboratory technician is a person certified by and registered with the Board of Medical Technology and qualified to assist a medical technologist and/or qualified pathologist in the practice of medical technology as defined in the aforementioned act ection 2, 4.) There are certain qualifications other than what is stated above to become a medical ‘technician provided that he or she satisfies the qualifications such that he or she: a. Failed to pass the medical technology licensure examination given by the Board of Medical Technology but obtained a general rating of at least 70% and provided finally that a registered medical laboratory technician when employed in the government shall have the equivalent civil service eligibility not lower than the second grade; b. Passed the civil service examination for medical technicians given on March 21, 196 or ¢. Finished a two-year college course and has at least one (1) year experience of working as a medical laboratory technician; provided that for every year of experience in college, two (2) years of work experience may be substituted; and provided further, that the applicant has at least ten (10) years of experience as medical laboratory technician as of the date of approval of this decree. Phlebotomist A phlebotomist is an individual trained to draw blood either for laboratory tests or for blood donations. When only small quantities of blood are needed, a phlebotomist can draw blood by simply puncturing the skin but when larger volumes of blood are needed, venipuncture or even arterial puneture is done. Arterial collection can only be performed by a specially trained phlebotomist. Nowadays, phlebotomy is a skill confined not only to medical technologists but to other health care practitioners as well, provided that they were given certification by a reputed certifying or training body.Defining the Practice of the Medical Technology/Clinical Laboratory Science Profession In the Philippines, a medical technologist is required to be skilled in phlebotomy. Although, in other countries, phlebotomists need not get a degree (Cardona et al., 2015). They are trained on the job and go through phlebotomy programs sponsored by community ges which take as little time as two months. After completing the program, they may take & examination for them to be recognized as a certified phlebotomist by the American Society é al Pathology (ASCP), American Medical Technologist (AMT), and the National ithcareer Association (NHA). Cytotechnologist A cytotechnologist is a laboratory personnel who works with the pathologist to detect es in body cells which may be important in the early diagnosis of diseases. This is rily done by examining microscopic slides of body cells for abnormalities or anomalies = structures, indicating either benign or malignant conditions. A cytotechnologist selects and minute particles of human tissue for microscopic study, using microtomes and other ment and employs stain techniques to make cell structures visible or to differentiate its The Papanicolaou (Pap) test and the H&E are the most commonly employed staining iques. Histotechnologist A histotechnologist, also referred to as histotechnican, is a laboratory personnel msible for the routine preparation, processing, and. staining of biopsies and tissue ‘oscopic examination by a pathologist (Cardona, 2015). Although there is no training for histotechnologists in the Philippines, being a histotechnologist is perceived % be a decent paramedical profession abroad. In the United States, one can complete jotechnician program accredited by the National Accrediting Agency for Clinical ratory Science (NAACLS). This program usually takes a year to complete and covers s in chemistry, histology, immunology, biochemistry, and medical ethics. Aspiring echnologists can also complete an associate degree program in a reputable health facility includes supervised histology training to gain an associate degree in Applied Science major in Histology. Nuclear Medical Technologist A nuclear medical technologist is a health care professional who works alongside nuclear sicians. Nuclear medical technologists apply their knowledge of radiation physics and y regulations to limit radiation exposure, prepare and administer radiopharmaceuticals, and use radiation detection devices and other kinds of laboratory equipment that measure quantity and distribution of radionuclides deposited in the patient or in the patient's specimen,30 Principles of Medical Laboratory Science Toxicologist A toxicologist studies the effects of toxic substances on the physiological functions of human beings, animals, and plants to develop data for use in consumer protection and industrial safety programs. He or she also designs and conducts studies to determine physiological effects of various substances on laboratory animals, plants, and human tissue, using biological and biochemical techniques. @ KEY POINTS + Medical laboratory science is one of the most important fields in the health care delivery system. It plays an important role in the diagnosis, treatment, and management of disease. + Medical technology is designed to improve the detection, diagnosis, treatment, and monitoring of diseases. + R.A. 5527 or the Medical Technology Act of 1969 defin: Medical Technology profession in the Philippines. s the nature and scope of the0 POST-TEST Name: Section: Instructions: Read each line answers on the space provided a: Defining the Practice of the Medical Technology/Clinical Laboratory Science Profession Score: Date: carefully and determine what is being described. Write your Itis also known as Republic Act 5: He or she is a laboratory personnel engaged in the practice of medical technology He or she is a laboratory personnel engaged solely in the collection of blood, Itis the year R.A, 5527 was enacted. He or she is a graduate of medical technology with board rating lower than 74.9%. 31Detining the Practice of the Medical Technology/Ciinical Laboratory Science Protession ‘3 @ ENHANCEMENT/REINFORCEMENT OF LEARNING Instructions: Interview a registered medical technologist using the questions below and submit a transcript of the interview on the next meeting. 1. In what section of the clinical laboratory are you assigned? 2. What are your responsibilities as a medical technologist? How do you handle the problems you encounter in your department? What do you have to say to someone aspiring to become a medical technologist? Oo REFLECTION Instructions: Answer the questions briefly. 1. How do you see yourself in the next 3 to 4 years or after finishing your Medical Technology degree? 2. What are the important roles of medical technologists that you need to adhere to when. you start practicing the profession?