Medical laboratory governance beyond rhetoric: Who should control diagnostic services in Ghana? 2

The first part of this article was published on Wednesday May 13, 2026.

Claims that laboratory physicians have been excluded from laboratory spaces must be treated with caution. In modern systems, access is governed by role and function, not professional identity.

Physicians continue to engage with laboratory services through clinical consultation, result interpretation, and multidisciplinary decision-making. 

However, unrestricted access to analytical workflows is not a universal requirement and is often regulated to maintain quality and safety standards.

Equally, the frequent appeal to “international best practice” requires closer scrutiny.

There is no single global model that places laboratories exclusively under physician control. 

In the United Kingdom, biomedical scientists lead laboratory operations while pathologists provide clinical oversight.

In the United States, laboratory leadership may be held by physicians or doctoral-level scientists.

South Africa’s system reflects a hybrid approach.

Across these contexts, the consistent principle is clear: laboratory governance is collaborative and functionally differentiated.                     

The argument that MLS leadership represents “scope creep” also warrants reconsideration. Laboratory medicine is inherently interdisciplinary.

MLS professionals are not seeking to perform clinical roles; rather, they are exercising leadership within their legally defined technical domain.

Framing this as encroachment risks obscuring the very structure that ensures diagnostic accuracy.                                                                  

Patient safety, often cited as the central concern, must be grounded in evidence.

Laboratory quality is measured through objective indicators, error rates, turnaround times, proficiency testing and accreditation standards such as ISO 15189.

These systems place primary responsibility for quality management and analytical validation in the hands of trained laboratory professionals.

Without empirical data demonstrating compromised performance, claims of risk remain speculative.

Toward a co-governance model for laboratory systems                                            

Ultimately, the current standoff reflects not just a professional disagreement but a governance gap.

Sustainable solutions will not come from industrial action or institutional dominance.

They will emerge from a clear, structured model of co-governance, one that recognises the distinct but interdependent roles within laboratory medicine.                                                            

In such a model, MLS professionals would lead laboratory operations, quality assurance and technical validation, while laboratory physicians would lead in clinical interpretation, consultation and test utilisation.

This is not a compromise; it is the model underpinning high-performing laboratory systems globally.

Beyond professional contestation                                                    

The debate at Korle Bu should ,therefore, not be framed as a contest for control, but as an opportunity to modernise laboratory governance in Ghana.

The strength of diagnostic services lies not in hierarchy, but in the integration of complementary expertise within a regulated, quality-driven system anchored in mutual respect and recognition of distinct professional mandates and professional autonomy.

The writer is a Lecturer/consultant Medical Laboratory Scientist, University of Health and Allied Sciences (UHAS), Ho.