Economic forces have been set in motion by recent legislation that are very likely to reduce available funds for clinical laboratories in hospitals. The effect of these impending developments on patient care is of great concern to clinicians and laboratorians. There is a range of available coping strategies that have broadly different consequences for the traditional role of the laboratory in patient care. The first seeks to preserve existing test ordering and reporting behavior by employment of straight cost cutting in the laboratory. The second calls for consciously determined selective degradation in laboratory services and functions. The third depends on decreased utilization of the laboratory achieved by indirect or direct intervention by laboratorians on the free ordering practices of clinicians. The fourth involves reorganization of the laboratory with new institutional relationships that variably affect laboratory function.