LESSON 2

Defining thee Practicte of thee eeiictal Tecthenolog Clinictal Labiorator cctiencte Profession

INTENDED LEARNING OUTCOMES

1. At the end of the lesson, the students should be able to

2. Discuss the practce of medical technology focusing on the nature of the profession in relaton to
the detecton and diagnosis of disease and
3. differentate medical technologists from other laboratory personnel such as laboratory
technicians pathologist and the like.

Nature of eeiictal Tecthenolog

The medical technology profession contnues 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 connecton

between science and technology. Science is primarily concerned with the study of the natural world and
the interrelatonship 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 scientic disciplines and areas such as
chemistry, electronics, optcs and mechanics, among others, in order to develop a utliiable
biotechnology that will aid in the diagnosis of diseases.

Technology, on the other hand, is the applicaton of science in ways that are considered
beneicial to society. Technology can be deined in three ways: irst, as a physical artefact, machine, or
instrument; second, as an actvity or a means to accomplish a goal; and third, as knowledge (Howell,
1996). Rogers (1983) asserts that “technology is a design for instrumental acton that reduces the
uncertainty in the cause-effect relatonships 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 informaton 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 abilites to create, invent, discover, or innovate to make the world a beter place to live
in.

Medical technology is designed to improve the detecton, diagnosis, treatment, and monitoring
of diseases. As such, it has linkages with many other disciplines for speciic diagnostc or therapeutc
purposes (Evans et al., 2003). Its nature is contextual, interdisciplinary, interdependent, and systems-
based. It is dependent on the applicaton, purpose, environment, and setng in which it is applied.

Clinical laboratory testng plays a crucial role in the detecton, diagnosis, and treatment of
diseases. Clinical laboratory scientsts who perform most of these laboratory tests, are involved in the
examinaton and analysis of body fuids, tssues, and cells. Laboratory scientsts usually look for the
presence of bacteria, parasites, and other microorganisms in the body. They analyie the chemical
contents of fuids, match blood for transfusions, and test for drug levels in the blood to show a patentts
response to a speciic treatment. They also prepare specimens for examinaton, to count cells, and look
for abnormal cells in the blood and other body fuids. They use microscopes, cell counters, and other
sophistcated laboratory equipment. They also use automated equipment and computeriied
instruments capable of performing a number of tests simultaneously. Afer testng and examining a
specimen, laboratory scientsts analyie the results and relay them to physicians.

With increasing automaton and innovatons in computer technology, the work of technologists
and technicians has become less hands-on and more analytcal. The complexity of tests performed, the
level of judgment needed, and the amount of responsibility assumed by the laboratory personnel are
grounded on extensive educaton and experience.

eeiictal Tecthenolog Practicte Definei

In the Philippines the medical technology profession and its practce is governed and deined in
secton two (2) of R.A. 5527, also known as the Medical Technology Act of 1969 Secton 2 of the Republic
Act, as amended by R.A. 6132, P.D. 498, and P.D. 1534, deines the practce of medical technology:

Secton 2. a. Practce of Medical Technology A person shall be deemed to be in the practce of

medical technology within the meaning of this Act, who shall for a fee, salary or other compensaton 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 promoton of health in general:

1. Examinaton of tssues, secretons and excretons of the human body and body fuids 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;
3. Parasitologic, mycologic and microbiologic procedures
4. Histopathologic and cytotechnology, provided that nothing in this paragraph shall inhibit a duly
registered medical laboratory technician from performing and techniques; histopathologic
techniques and procedures;
5. Clinical research involving patents or human beings requiring the use of and/or applicaton of
medical technology knowledge and procedures;
6. Preparatons and standardiiaton of reagents, standards, stains and others, provided such
reagents, standards, stains and others are exclusively for the use of their laboratory;
7. Clinical laboratory quality control;
8. Collecton and preservaton of specimens;

Provided, That any person who has passed the corresponding board examinaton for the
practce of a profession already regulated by existng 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 (Secton 2, a.).
 All aforementoned are commonly observed in a clinical laboratory (Cardona et al., 2015).
However, some of these may not be exclusive to medical technologists. Microbiologists, biologists,
chemists, and even sanitary engineers may be involved in some actvites usually done by medical
technologists. A medical technologist must irst become licensed before he or she is permited to
practce the profession. Practcing as a medical technologist without a license is punishable by law. It
should also be considered that the medical technology practce should be bound by the accepted pledge
of oath in accordance with the Code of Ethics of Medical Technology which states that the Medical
Technology professional should accept the responsibilites inherent to being a professional and shall not
engage in any illegal actvites. The following are the original and revised versions of the medical
technology code of ethics.

Original version (bi Dr. Nariito eoraleta)

Upon entering into the practce of medical technology let it be known that:

I accept the responsibilites associated with my dutess

I shall uphold the ideals of my professions

I am aware that since the physician relies upon my work in the diagnosis and treatment of diseases, any
error may afect the health or even the life of the patents Every procedure and observaton therefore
must be carried out with absolute reliability, accuracy, fairness, and honestys

I am aware of the need for mutual understanding and cooperaton among my fellow workers in the
medical and paramedical feld in the pursuance of a worthy causes

I shall strive to preserve the integrity of myself and the professionals from whom we expect the sames

I shall strive to develop necessary virtues needed in my work and shall place my service above any other
consideratonss

I shall restrict my phrases, critcisms, values, and opinions, within constructve limits and I shall not use
the knowledge I know as a tool for my selfsh personal endss

I realize that the knowledge I acquired about any individual in the course of my work must be treated as
confdentals Aond since the physician has the ultmate responsibility in the diagnosis and treatment, my
result must be known only by hims I shall neither make diagnosis nor interpretatons other than this in
the report made by me nor shall I advice the physician or others on how to treat diseasess

I shall believe in full and equal opportunites in the pursuance of our ideals within the context of the
principles of human rightss

To these principles, I hereby subscribe, promising to conduct myself at all tmes in a manner appropriate
to the dignity of my professions
Revisei version (bi Prof. Roiolfo Rabior)

Aos I enter into the practce of edical Technology, I shall accept the responsibilites 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 associatng or being identfed with any enterprise of questonable 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 competton for professional employment or services and shall refrain
from unfairly injuring, directly or indirectly, the professional reputaton, 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 confdence 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 confdence whether they are subordinates or employees,
authors of proposals for grants or contracts, authors of technical papers or other publicatons or involved
in litgaton;

I shall advance the profession by exchanging general informaton and experience with fellow medical
technologists and other professionals and by contributng to the work of professional organizatons;

I shall restrict my praises, critcisms, views, and opinions within constructve limits and shall not use the
knowledge I know for selfsh ends; I shall treat any informaton I acquired about individuals in the course
of my work as strictly confdental, and may be divulged only to authorized persons or enttes or with
consent of the individual when necessary:

I shall report any infractons of these principles of professional conduct to the authorites responsible for
the enforcement of applicable laws or regulatons, or to the Ethics Commitee of the Philippine
Aossociaton of edical Technologists as may be appropriates

To these principles, I hereby subscribe and pledge to conduct myself at all tmes in a manner befing the
dignity of my professions

Roles ani Responsibiiliies of eeiictal Tecthenolog 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
practce. In the Philippines, R.A. 5527 or the Medical Technology Act of 1969, deines 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 practtoners to provide humane and digniied
health service. The following are the tasks of medical technology professionals in the practce of
laboratory science.
Perform Clinical Laboratory Testng

A medical technologist must be capable of performing the most basic to the most advanced
laboratory tests. A graduate of Bachelor of Science in Medical Technology/Medical Laboratory Science is
expected to show competency in performing routne laboratory tests including urinalysis and stool
examinaton. He or she should be capable of performing hematologic, microbiologie, serologic,
chemical, and other procedures in the different areas of laboratory science. In turn, it is expected that
the clinical laboratory will be equipped with the resources necessary for performing such procedures or
any kind of laboratory testng.

Perform Special Procedures

Medical technologists are also expected to perform special procedures in diagnosing diseases.
These may include the operaton of advanced diagnostc equipment. Special procedures can also include
molecular and nuclear diagnostcs.

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 testng process and its results. Accuracy and
precision impacts the interpretaton of results by the physician to provide proper medicaton in the
treatment of diseases.

Be Honest in Practce

A practcing medical technologist, like any other professional, is expected to be honest in the
practce of his or her work. It is important that a medical technologist values honesty, partcularly in
conveying or reportng the results of any laboratory procedure. He or she should act according to the
Medical Technology professionts Code of Ethics and his or her pledged oath of practce. A medical
technologist must be honest at all tmes in the conduct of test procedures to come up with accurate and
precise results.

Ensure Timely Delivery of Results

In collaboratng with other health care practtoners, a medical technologist must be aware of
the urgency of delivering results on tme especially in cases that require urgent treatment. There are
tmes when physicians will request laboratory tests which require immediate acton. One should take
notatons on “STAT” or even observe the source of the requests (e.g., from the emergency room [ER] or
operatng room [OR]). It is important for a medical technologist to be alert to fully address the needs of
the patent. Since some laboratory procedures are tme bound, it is important that a medical
technologist is able to perform the dutes required of him or her, as soon as possible.
Demonstrate Professionalism

A medical technologist must be able to perform his or her functons according to the
Professional Code of Ethics for medical technology professionals. He or she should be aware of the laws
and regulatons governing the practce of medical technology and should not exploit its functon beyond
its boundaries. In the Philippines, the practce of medical technology profession is governed by R.A. 5527
or the Philippine Medical Technology Act of 1969. Other governing regulatons 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). Natonal organiiatons such as the Philippine Associaton of Medical Technologists, Inc.
(PAMET) and the Philippine Associaton of Schools of Medical Technology and Public Health, Inc.
(PASMETH) also have their own consttutons and by-laws in accordance with the governing laws and
code of ethics.

Uphold Conidentality

Ensuring conidentality of patentts informaton is one of the core dutes within the medical
practce (De Bord et al.). Conidentality requires health care providers to keep a patentts personal
health informaton private unless the patent consents to release the informaton. Patent records are
expected to be kept in conidence by the medical technologist. It is expected that these records
containing very important informaton are protected and made available only when necessary. A
medical technologist must be aware at all tmes of the value of conidentality and the entrety of the
ethical codes of their profession.

Collaborate with Other Health Care Professionals

A medical technology professional is required to collaborate with other health care practtoners
in order to build a well-functoning team. Most ofen, projects fail because people fail to cooperate with
others. Collaboraton is the act of working together in order to achieve a desired outcome. Success in
the health care setng is achieved not because of the availability of highly sophistcated hospital or
laboratory equipment, but because of teamwork. A highly-trained physician will only be able to
efficiently treat his or her patent if laboratory testng, monitoring, drug prescripton and dosage, and
more are properly rendered and administered by other health care professionals. These protocols
cannot be done by the physician alone. Having one non-collaboratve and incompetent member in the
team alone can result in potentally dire repercussions.

Conduct Research

Practcing medical technologists must also be engaged in research actvites to update their
skills. Research work, whether experimental or descriptve can contribute signiicantly to the discovery
of new knowledge in the ield of medical technology and in assessing and revisitng already known ones.
It can greatly help in the further development of the ield and may be used as future reference for
patent care.
Involvement in Health Promoton Programs

Medical technologists should not be conined only to the four corners of their clinical
laboratories. Medical technology is a mult-disciplinary ield which consistently ventures into other areas
of health care including health promoton. A medical technology professional must be actvely 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 care 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 health promoton campaigns such as
promotng the ideal attudes on hygiene, community sanitaton, waste segregaton, and disease
preventon.
2. Implement pre-planned programs of health promoton campaigns.
3. Offer free laboratory testng such as blood typing, urinalysis, fecalysis, blood sugar testng,
cholesterol testng, and other tests beneicial to the entre community.
4. Collaborate with other health care professionals once diagnoses are done.

Defining thee Practicte of Otheer Labiorator Personnel

The following is a list of other valuable laboratory personnel with various roles in the health care
delivery system, speciically in the area of laboratory medicine. It is important to note that medical
technologists work closely with these laboratory personnel in order to 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 patent care.

Pathologist

As deined 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 interpretaton of tssues, secretons and excretons of
the human body and its functons in order to diagnose disease, follow its course, determine the
effectvity of treatment, ascertain cause of death, and advance medicine by means of research (Secton
2, b.).

A pathologist is always considered to head a clinical laboratory and monitor all laboratory results. A
laboratory result without the signature of a pathologist may not be considered valid.

Medical Laboratory Technicians

As deined in R.A, 5527:

 A medical laboratory technician is a person certied by and registered with the Board of Medical
Technology and qualiied to assist a medical technologist and/or qualiied pathologist in the practce of
medical technology as deined in the aforementoned act (Secton 2, d.).

There are certain qualiicatons other than what is stated above to become a medical technician
provided that he or she satsies the qualiicatons such that he or she:

a. Failed to pass the medical technology licensure examinaton given by the Board of Medical
Technology but obtained a general ratng of at least 70% and provided inally 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 examinaton for medical technicians given on March 21, 1969; or
c. 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 substtuted; 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
donatons. When only small quanttes 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
puncture is done. Arterial collecton can only be performed by a specially trained phlebotomist.
Nowadays, phlebotomy is a skill conined not only to medical technologists but to other health care
practtoners as well, provided that they were given certicaton by a reputed certfying or training body.

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 colleges which take as litle tme as two
months. Afer completng the program, they may take an examinaton for them to be recogniied as a
certied phlebotomist by the American Society for Clinical Pathology (ASCP), American Medical
Technologist (AMT), and the Natonal Healthcareer Associaton (NHA).

Cytotechnologist

A cytotechnologist is a laboratory personnel who works with the pathologist to detect changes
in body cells which may be important in the early diagnosis of diseases. This is primarily done by
examining microscopic slides of body cells for abnormalites or anomalies in structures, indicatng either
benign or malignant conditons. A cytotechnologist selects and sectons minute partcles of human tssue
for microscopic study, using microtomes and other equipment and employs stan techniques to make cell
structures visible or to differentate its parts. The Papanicolaou (Pap) test and the H&E are the most
commonly employed staining techniques.
Histotechnologist

A histotechnologist, also referred to as histotechnican, is a laboratory personnel responsible for

the routne preparaton, processing, and staining of biopsies and tssues specimens for microscopic
examinaton by a pathologist (Cardona, 2015). Although there is no formal training for
histotechnologists in the Philippines, being a histotechnologist is perceived to be a decent paramedical
profession abroad. In the United States, one can complete a histotechnician program accredited by the
Natonal Accreditng Agency for Clinical Laboratory Science (NAACLS). This program usually takes a year
to complete and covers courses in chemistry, histology, immunology, biochemistry, and medical ethics.
Aspiring histotechnologists can also complete an associate degree program in a reputable health facility
that includes supervised histology training to gain an associate degree in Applied Science (AAS) major in
Histology.

Nuclear Medical Technologist

A nuclear medical technologist is a health care professional who works alongside nuclear
physicians. Nuclear medical technologists apply their knowledge of radiaton physics and safety
regulatons to limit radiaton exposure, prepare and administer radiopharmaceutcals, and use radiaton
detecton devices and other kinds of laboratory equipment that measure the quantty and distributon
of radionuclides deposited in the patent or in the patentts specimen.

Toxicologist

A toxicologist studies the effects of toxic substances on the physiological functons of human
beings, animals, and plants to develop data for use in consumer protecton 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 tssue, using biological and biochemical
techniques.