As the diagnostic test menu has increased in size and complexity, healthcare providers are in great need of advice on appropriate test selection and result interpretation. To address this need, diagnostic management teams headed by expert lab leaders have emerged in multiple clinical areas. Despite the great clinical need for such consultative advice for large numbers of patients, diagnostic management teams have been implemented in a limited number of institutions. This presentation will address the details of the 4 main barriers to implementation. The first barrier is the modest or absent payment for this important clinical activity. The second barrier is the limited number of individuals available to provide expert advice on test selection and result interpretation. The third problem relates to the technical issues of connectivity between the laboratory expert and the healthcare provider requesting advice. Finally, the fourth major barrier is the change in culture required within our own discipline to prioritize patient care at or above specimen management. These 4 barriers will be discussed and potential solutions will be offered.