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L-Soft Interviews Pat Letendre

Pat Letendre

Q: For ten years now you have run the largest English-language email list for medical laboratory professionals, MEDLAB-L. How did it originally get started?

A: In 1994 the Internet had just become available at the University of Alberta where I taught in the Division of Medical Laboratory Science. I read about the possibility of creating an email list to facilitate communication with colleagues around the globe, and it seemed a wonderful opportunity to share experiences and help solve common problems. Instead of creating a list for my specialty (transfusion medicine), I decided to create one for all of laboratory medicine since we shared similar challenges and some of the traditional divisions between laboratory specialties were beginning to blur.

MEDLAB-L was originally hosted by the University of Alberta using LISTSERV software. However, when they decided to use other software for their lists, to maintain LISTSERV benefits I approached the University at Buffalo to host the list, and they generously consented. To me it was essential to retain LISTSERV with its must-have features, such as the ability to perform advanced archive searches using both email and a Web interface and to provide virus and spam protection.

Q: Why in your opinion has this list thrived for as long as it has?

A: The list has thrived for several reasons. First, because medical laboratory science is the third largest profession of health care workers in the world, we have many potential subscribers and most use computers as part of their jobs. Second, the list has subscribers from all specialities and with diverse qualifications, e.g., medical laboratory scientists and technologists, physicians, PhD-level scientists, educators, students, sales and service representatives, laboratory information specialists, etc. Hence, subscribers enjoy the diversity and benefit from cross-pollination of ideas. Third, despite working in a fast-paced environment filled with pressure, list members are incredibly generous in supporting one another. Because they work behind the scenes to diagnose disease and monitor patient therapy, the profession is largely invisible to the public. Being the unsung heros of health care, subscribers feel a special collegiality. Fourth, everyone on the list uses first names, not titles. Opinions stand and fall on merit rather than professional status, which is refreshing in a field with a pecking order that places physicians at the top.

Q: And why did you start the second list, also unique because it is the only bilingual (English-French) email list for transfusion medicine professionals?

A: The English-French list ("transfusion") met a real need within Canada, where almost 25% of the population is francophone. In the late 1990s the new job category of transfusion safety officer (TSO) was created in Canada's blood system. Consisting of both medical technologists and nurses, many TSOs were located in the French-speaking province of Quebec. To meet the need for national communication between both language groups, the TSOs asked me to create a bilingual Website and mailing list. Based on my experience with MEDLAB-L, I choose LISTSERV and opted for L-Soft's economical EASE Home service to host "transfusion."

Q: Do you think either of these lists has directly or indirectly saved lives or influenced advancement in the field of medicine?

A: Unquestionably, both MEDLAB-L and "transfusion" have enhanced best practice and patient safety. Both lists are fortunate to have subscribers who are internationally recognized experts and who continually promote best practices backed up with experience and scientific literature, where available. A mailing list with searchable archives is one way to combat the severe loss of expertise due to centralization and downsizing of the clinical laboratory sector and approaching retirement of many baby-boom health professionals. Lists such as MEDLAB-L create a common repository of practical experience and tacit knowledge that is not found in published literature.

About saving lives, over the years MEDLAB-L has had several "real-time" urgent requests for help, often for patients with life-threatening bleeding and for whom compatible blood was unavailable for transfusion. Subscribers responded quickly, sometimes resulting in happy endings and sometimes not, as patients were too ill to recover. Other examples include helping colleagues interpret abnormal laboratory results for acutely ill patients. Besides promoting best practice and solving problems, both lists have been invaluable in facilitating workers in isolated locations around the globe connect with experts.

Q: If you started another email list, what subject and/or purpose would it focus on?

A: I'd love to start a list for helping colleagues use the Internet effectively, to include basic computer skills and strategies for evaluating Internet resources. Despite using computers on-the-job, most health professionals have never learned the fundamentals of Internet use, including how to use browsers and related software effectively, and other basics such as "netiquette." As a small start I created the sometimes irreverent "L-netiquette" for MEDLAB-L users:

Q: You have been teaching people how to use the Internet for professional development for many years. What is the very first bit of advice that you usually give them?

A: After stressing that they get virus protection and a firewall, the next advice I give is to learn how to evaluate Internet resources. So many professionals forget to critically analyze information on the Net. Everyone who uses the Internet should be taught effective search techniques and how to assess the validity of resources using quality indicators and an evidence-based approach. Because list discussions are not peer reviewed prior to publication, subscribers should also assess the validity of information using defined standards, the same as they would if it were presented at conferences or in journals. Fortunately, peer review happens once a message is posted; on a list with experts, others will correct misinformation and discuss whether the information is opinion or evidence-based.

Q: As a consultant, have you recommended the use of email lists and if so for what purposes?

A: I have recommended mailing lists often, usually for health professionals to communicate with local and international colleagues. Other recommendations include course lists for instructors to communicate with students and one-way distribution lists and newsletters for organizations to inform members about Website updates, upcoming events, important changes, etc.

Q: In 2002 you won Tech Sample of the Year from the American Society of Clinical Pathologists, can you talk about this some more?

A: The ASCP Tech Sample series is a home-study program of case studies that provides continuing education credits needed for medical technologists to meet state licensure and other government competency regulations. Each case has learning objectives and a quiz. My case was about a patient who experienced a life-threatening transfusion reaction. Interestingly, I was asked to develop the case study by a MEDLAB-L subscriber who happens to be the chair of the Tech Sample committee and who would never have heard of me were it not for the list.

Q: Your achievements and awards are really impressive, which one means the most to you personally?

A: That's a tough one as each award is special and I have been blessed by kind friends who make good things happen. The award I feel most honored to have received is the 1996 award presented in Oslo from the International Federation of Biomedical Laboratory Science because it was selected by international peers and was the first time a Canadian or any North American had received it. The award was largely based on the creation of MEDLAB-L, as well as on writing a textbook on scientific writing that was translated into Japanese. The honor happened because colleagues put time and effort into supporting my nomination. A list such as MEDLAB-L would have been created eventually, but I was the lucky person to have thought of it first.

Q: Do you think the United States could ever have a free public health care system such as the one in Canada?

A: Speaking off the cuff, I think that the USA will never have a publicly funded health care system with universal access like Canada's and, for that matter, like the rest of the countries in the developed world, all of whom have public health care. I am a political junkie who follows American politics and current events closely, facilitated because Canadians have easy access to American television and print media.

One key factor is the strength of U.S. political action committees (PACs) and other powerful lobby groups who oppose a publicly funded system with universal access. Such groups are able to spread their viewpoints among the public and have the financial clout to target and defeat politicians who support a public system. Many other factors play significant roles but I'll stop here as I would be venturing into political territory where only the foolish or brave dare to tread. (big grin)

Pat Letendre, MEd, specializes in Internet training, information retrieval and analysis, communication skills, and transfusion medicine education. She has 22 years experience as an educator and clinical instructor, including 10 years teaching how to use the Internet for professional development.

Pat began consulting part-time in 1996 and became a full-time consultant in May 2000. She retains an appointment as an assistant clinical professor at the University of Alberta.

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