In this issue, Prinsloo and Gray report the results of a 137-laboratory audit on clinical authorization using the guidelines and standards from the Royal College of Pathologists. Only 33% of laboratories were found to be compliant with the standards, although many showed evidence of good practice. Clinical authorization is resource-hungry and the question raised by this study is whether adhering to the letter of the standards set by the Royal College of Pathologists is actually in the best interest of the patient and provides overall value for money, when the latter is key to optimizing the quality of service.