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Cooperation Clinical chemists ’discovered’ automation some twenty years ago and, as instrument users, have spent these last two decades alternating between hope and deception. They are now disillusioned people. Each year brings a fresh crop of original systems, but chemists have found that they have only one chance in ten of purchasing a useful instrument since there is no way of telling the good from the bad on an exhibition stand. remember a closed meeting held in Munich in 1978 between users and suppliers of laboratory products, which discussed the recurring problems of communication and cooperation. A top executive of a leading company, apparently exasperated by the usual mistrusting comments of the laboratory professionals, suddenly burst out ’The instrument companies have raised your profession to its present status. Without us you would still be playing with test tubes and bunsen burners down in the basements of your hospitals! You can’t just go on ignoring what you owe to industry, treating us as junior partners, closing the door in our faces when we try to join your panels but at the same time asking for more and more free reagent samples and unlimited, unconditional instrument evaluation This is the gist of what he said, but he was most sincerely upset by the reaction of the laboratory professionals. Meanwhile, was wondering why it was that an instrument evaluation in perhaps another country or by a different laboratory is never good enough for one’s own purposes. Instrument evaluation is a highly expensive activity in our laboratories even without such duplication. realized then that wasn’t the only one to be unhappy with the situation, and that the communication gap was probably much larger than had suspected. No matter how much closer to each other the two sides may draw, cannot see the clinical chemist feeling indebted to industry for having contributed to the present status of his profession, nor will he expect any acknowledgement from industry. Cooperation in this context simply means that we try to add rather than cancel our respective efforts and expertise in an area of common interest. It is a means to self-realization, and has not a great deal to do with mutual support. Indeed, we can only agree on means: our aims are different. Industry sells, we analyse. The common area is the instrument, but its definition is equivocal: for industry it is a product, to us it is a tool. And all too often it is prototype and a nuisance. Good communication must be sought at a still more basic level. Only when we have agreed proper definitions for such terms as ’sample throughput’, ’throughput time’, ’volume ratio’, ’photometric accuracy’, ’carry-over’ etc., will those terms carry unequivocal information. The role of industry as a leading force in the technological development of laboratories cannot be questioned. What can be questioned is the ultimate value of this development for which industry cannot be completely blameless. The truth is that we have no reason to be too proud of clinical chemica! practice today. But if industry insists on sharing credit for our successes, it must also be prepared to accept some responsibility for our failures. It is not my intention here to detail the successes, since they have been exhaustively discussed elsewhere ]. It is undeniable that the remarkable improvements in kinetic analysis or particle counting, for example, owe a great deal to new technologies and demonstrate that cooperation can be fruitful. For the purpose of this paper I would like to elaborate on the three points introduced above: the unhappiness, the communication gap, and the degradation of clinical laboratory practice. will then conclude with the user’s needs. As a preface, let me make one general statement: am neither complaining, nor casting stones. am trying to understand. People are no better and no worse whether they belong to industry, to scholarship, or to medicine. However, the systems, i.e. the existing relationship between each decision group, must be criticized. This is a prerequisite for positive change, which in turn can only come from individual initiatives.

Automated systems for the clinical laboratory: the user's needs