The discipline of clinical chemistry is undergoing dramatic changes. The force for change stems from a worldwide recognition of the importance of chemical analyses in medical practice. In the past, developments in clinical chemistry were initiated from a technical perspective. This report provides an alternative approach, starting from the patient and then defining the role of the clinical chemistry laboratory in patient care. The discussions attempt to define the relationship between patient care and analytic goal development in statistical terms. This approach provides a method for appraising the needs of medical care in quantitative terms from the perspective of the physician and the patient. The approach also provides guidance for identifying areas where further technical advance is required, as well as areas where present laboratory performance is adequate for patient care in terms of analytic quality.