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To the Editor.— I first learned of the 2 articles on physicians' office laboratory testing^1-2 via the lay press (in this case, the Chattanooga Times). The headline implied that patients receive inferior care if laboratory services were performed in physicians' offices, when in fact the purpose of the 2 articles was to assess the accuracy of proficiency testing (PT) at various sites. Although PT is a valuable tool in maintaining quality results, it is only a small part of a total quality control program. Quality control for the laboratory begins with test ordering and includes many steps until the desired test results are reviewed by the ordering caregiver.

The "Comment" section of the first article¹ mentioned that 90% of detected problems with laboratory services occur during the preanalytic and postanalytic phases.^3-4 In comparison, the articles in JAMA detected small but statistically significant differences in proficiency test results from various . . . [Full Text of this Article]

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