Tag Archives: clinical microbiologist

“The Charlatan Microbiologist”

I still get a little nervous every time my work phone rings…

Will it be a question that I am unable to answer? (I get a few of these)

Will it be a complaint about a result or some aspect of laboratory policy. (I get quite a few of these as well..)

Or will it just be a standard “bread and butter” clinical enquiry where the answer is engrained in my cerebellum?

Fear of the unknown…

I am not very good at remembering the 3rd line treatment for recalcitrant giardiasis.

I am not very good at thinking on my feet, especially in a stressful situation.

and I am not very good at documenting all the clinical advice I give out.

Sometimes I feel like a bit of a fraud…

But then I remember the things I am good at.

I am good at building relationships with clinicians and gaining their trust.

I am good at turning the conversation from “result interpretation” into “patient interpretation”

I am good at diffusing complaints with a healthy dose of empathy and a bit of Irish charm.

I am good at knowing when and who to ask if I have a difficult microbiological problem.

On reflection, I am not completely useless.

Maybe we are all charlatans in some respect. We all have limits to our microbiological knowledge, our patience, our energy reserves.

And it is good to remind ourselves that it is often the non-microbiological aspects of our job that are the most important…

Michael

“A decade as a microbiologist in New Zealand”

"There are worse places to work than the Bay of Plenty, NZ"
“There are worse places to work than the Bay of Plenty, NZ”

It is now 10 years since I started working as a Clinical Microbiologist in New Zealand. When I first arrived here from the UK, young, fresh faced and a little naive, I never dreamed I would still be in the same job 10 years later. For someone as restless as myself, 10 years is a Herculean effort, even if it was intersected by a 6 month sabbatical in Paris…

A lot has changed in my workplace over that decade. Paperless processing, laboratory mergers, Maldi-Tof technology, new laboratory buildings and the introduction of Kiestra TLA have made it an interesting and challenging period.

Outwith work, but within microbiology, I have enjoyed creating this website, and writing the book “The Art of Clinical Microbiology”. I just wish I had a bit more time to better develop and market these personal projects…

Likewise outside of microbiology, life has been equally eventful. Over the last decade, my family has grown from 3 to 7, one of whom needed emergency open heart surgery to successfully  correct a congenital heart condition. Running, travelling and learning French have been my other passions in my spare time. New Zealand is a beautiful country, which I have enjoyed getting to know.

I have a lot to be thankful for…

The 10 years in New Zealand have passed quickly. When you think about it, a decade is a big chunk of your life. I find it difficult to get used to the fact that I am no longer a “young” clinical microbiologist. Most days I reflect on where I am and where I am going.

I have aged somewhat in the last 10 years… I have become more streetwise, my skin has got thicker, and I am definitely more prepared to take risks. However I still love to daydream and create. I still have that rebellious streak in me and I like to do things a little bit differently from everyone else. I am still very much of a loner. Maybe I am becoming a middle-aged existentialist!

The world of Clinical Microbiology in New Zealand is a small one. New opportunities are not abundant. The politics can be difficult, with laboratory services here tendered out to private providers on a contractual basis. Worldwide, the whole practice of microbiology is changing quickly. The ability to direct that change to some extent locally is absolutely key to keeping my notoriously low boredom threshold under check.

I love change. 

Where will I be in 10 years time? Who knows? Hopefully still alive, maybe even still a clinical microbiologist. 20 years in the same job would really be pushing the boundaries of my sanity, but I might hang on for a year or two yet….

Michael

 

 

“The Inbetweeners”

inbetweeners

Clinical Microbiologists, also known as Medical Microbiologists, now form part of the set-up of most clinical microbiology laboratories in the developed world. They are generally very well qualified people, most possessing a medical degree as well as post-graduate clinical and pathology fellowships. Thus they are not stupid, eccentric maybe, but not completely daft.

Their job description is sometimes difficult to define (I should know…). They are generally not clinicians, although they have a lot of clinical knowledge, nor are they technicians although again they know a lot about what happens on the benches.

They are essentially inbetweeners”.

So what exactly is the role of a clinical/medical microbiologist?

This of course varies depending on the type of laboratory and/or hospital you work in but I think the following should apply to and define all clinical/medical microbiologists:

  • Interfacing: Being able to form and strengthen the critical link between the laboratory and the clinician. This is not just about being a “result messenger”, but more importantly being able to communicate the importance/non-importance of specific results to the clinicians and along the same lines, being able to highlight the importance of particular samples to the scientists, so that time and energy can be focused.
  • Optimise use of antibiotics and the control of microbes within institutions: Better known as anti-microbial stewardship and infection control, which most clinical/medical microbiologists get involved with to a greater or lesser extent.
  • Ensure clinical appropriateness of testing: Ensuring that the tests being offered by the microbiology laboratory are the best that can be offered within the given budget, are the most clinically appropriate, and are utilised sensibly and appropriately by requestors. Clinical/medical microbiologists should also be responsible for filling in gaps in the microbiology testing profile of a laboratory and for getting rid of tests that are no longer current or best practice.
  • Guide the future direction of laboratory: Being able to outline where the microbiology laboratory needs to be in the future in terms of equipment, testing strategy and profiles offered, expected turnaround times etc.

 

Unlike clinicians with a list of patients, or microbiology scientists with a batch of tests, clinical/medical microbiologists may not have a lot of pre-determined tasks sitting waiting for them when they arrive at work in the morning. Thus a high degree of self motivation is necessary to address some of the “less than concrete” objectives above on a daily basis. This can be difficult when you are tired or under the weather, and at such times it can be easier when your day is mapped out for you….

Clinical/medical microbiologists overlap considerably with Infectious Diseases physicians in terms of their knowledge, but at the same time it is important to acknowledge that each group also possess distinctive skill sets. Will the “inbetweener” speciality of clinical/medical microbiology survive the automation of the microbiology laboratory? For my sake, I hope so, but it is important that the profession is able to accurately define itself, so that it can continue to fill a niche, and to serve a useful purpose.

Michael