A: I think the largest challenge that we as a company face is getting appropriate reimbursement for the tests that we offer. Many of these new tests require sophisticated sequencing machines. They require sophisticated PhDs or MDs to participate in the performance of the test or the evaluation of the test, and here in the United States, probably one of the main issues facing our legislators and regulators is the cost of health care. LabCorp needs to try and participate in that debate so we get our fair share of the health care dollar. The system in this country, whether it's a national or a large managed care system, continues to consolidate, and as a result, we have more and more large purchasers of lab services. We need to demonstrate to them, through economic studies and through performance-based testing assessments that the test that's being performed also not only impacts profoundly on the patient's status, also impacts on the overall savings in the health care system.

Q: What's one thing you didn't see coming?

A: I probably missed the boat in that I did not anticipate the enormous consolidation of the managed care industry and the speed that it has consolidated.

Q: What's the most innovative thing you've seen or heard of another company doing?

A: I'm from the health care industry. I've spent 25 to 35 years in health care and I don't think in my lifetime I've seen anything more profound than the sequencing of the human genome. ... Both through the public sector and private companies, we have sequenced the human genome. What that offers is the opportunity to understand individual gene structures in our body. What that will cause is our ability to predict, to understand and to treat earlier people's potential sickness, way, way in advance of when they would ever become sick.

Q: How about your company?

A: We have been able to benefit by preparing ourselves for having genes available to do medical testing. That's what I think is the most important decision we've made at LabCorp in last 10 years -- to be prepared to reduce the sequencing of the human genome to practice. As genes are identified, as mutations in genes are discovered, we have the ability to offer tests that are extremely helpful to individuals and potentially later on their families.

A good example of that is cystic fibrosis. The American Society of Obstetrics and Gynecology has said that any woman that has any caucasian blood in them and is of childbearing age should be tested to see if she is carrying the cystic fibrosis gene. If they are carrying it and their spouse is carrying it, there's a one-in-four chance that child that they bear will have cystic fibrosis. This was unknown in the year 1998 and it really didn't become knowable until we were able to sequence the cystic fibrosis gene and the mutations associated with it. ...LabCorp has taken significant advantage of this profound medical breakthrough called the sequencing of the human genome.

There are companies we get the tests from. We develop some of the testing methods ourselves. We now have the center for molecular biology and pathology over in Research Triangle Park, which is probably the most sophisticated lab-testing facility in the world. That's probably a wonderful example of all the things I've talked about. We have sequencers there, we have HIV testing there, we have PhDs there, we have MDs there, and we've had to staff up significantly here in the great state of North Carolina.

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