Something that keeps coming up in my PhD on capacity constraints to precision medicine is the increasing strain on pathology labs. Much of the focus is on genomics and novel treatments but most of these tests involve at least some sample processing in path labs My research on NSCLC suggests that in this area there is also a lack of clarity about how tests and test processing is paid for and in many instances its the path labs that pick up the bill. This creates tensions between test providers, test orderers and finance staff