The Emerging Role of the DCLS: Bridging the Gap Between Laboratory Medicine and Clinical Care

This is the latest episode of our From Pathogen to Infectious Disease Diagnosis podcast, where we discuss the relationship between clinicians and laboratory professionals.

The growing complexity of diagnostic testing in modern medicine has created an increasing need for stronger collaboration between laboratory professionals and clinicians. One emerging solution to this challenge is the doctor of clinical laboratory science (DCLS) role. During a recent Contagion^® podcast discussion, laboratory medicine expert Brandy Gunsolus, DCLS, described how the profession is evolving and why it is becoming an essential component of health care teams.

Gunsolus became the first individual in the United States to earn a DCLS degree, earning it through Rutgers University, and she explained that the role was developed to address a common challenge in clinical practice: Clinicians frequently have questions about diagnostic tests, interpretation of results, and appropriate testing strategies. Traditional laboratory training provides deep expertise in test performance and laboratory operations, but historically, there has been limited integration with clinical decision-making.

“As I'm graduating with my master’s, Rutgers announced that we are opening up the first DCLS program in the country. And when they explained what the DCLS was—being this bridge between the physician and the laboratory, helping with explaining what the results are and what the correct test is and the correct timing, and helping with the interpretation—I was like, ‘This is so needed,’” Gunsolus said.

By embedding laboratory expertise directly into clinical care teams, DCLS professionals help guide diagnostic strategies, assist with interpreting complex results, and support clinicians who encounter unusual or difficult cases. Physicians may consult the DCLS when test results appear inconsistent with clinical findings or when determining the next diagnostic step for a patient.

In addition to improving clinical decision-making, the role also contributes to laboratory stewardship and cost containment. Gunsolus described developing a pathology utilization program aimed at reducing unnecessary testing and improving ordering practices. Within 18 months, the program generated approximately $1.2 million in savings for the health system.

Much of this improvement comes from addressing common ordering errors. With thousands of laboratory tests available—many with similar names—clinicians working under time pressure may inadvertently order incorrect or redundant tests.

“There are so many tests that are out there that the name is so similar, and with physicians, there's a high demand on their time, and sometimes, they even pass that task on to their nurses. ‘Hey, I need you to order x, y, z,’ and then they don't know all the intricate details between the different ones, and they accidentally order the wrong test,” Gunsolus said.

By implementing education programs and electronic medical record safeguards, DCLS professionals help ensure the right test is ordered at the right time.

The role also has implications for health care access, particularly in rural areas facing shortages of pathologists and laboratory directors. DCLS-trained professionals can serve as clinical laboratory directors and provide expertise to facilities that may lack onsite pathology support.

Although the profession continues to grow, Gunsolus noted that it is best suited for laboratory professionals interested in direct collaboration with clinicians and active participation in patient care teams.

“A lot of people go into the laboratory profession because they love science; they love medicine, but they don't want to deal with people,” Gunsolus said. “You're going to have to communicate with people…. It's not for everyone, and you're going to have to take criticism. You're going to end up being that person who, when the physician is upset at the laboratory, it may not be you personally, but you're accountable…. You have to develop a thick skin. So it's not for everyone, but for those who can do it, it is so rewarding.”

As diagnostic testing becomes increasingly sophisticated, the DCLS role will play a critical role in ensuring that laboratory data are translated into meaningful clinical insights that ultimately improve patient outcomes.