Dr Mattman practices medical biochemistry with an eye to the present and an eye to the future. In the present, he is excited about improving patient care by provision of valuable diagnostic tests that are accessible to patients and their clinicians. He also see patients in the Adult Metabolic Diseases Clinic one day per week. Complementing this work is his education role as the program director for the UBC medical biochemistry program and as the past-chair of the Royal College national subspecialty committee for medical biochemistry. In that role, he developed the following thoughts regarding the future of medical biochemistry. We have a major role in laboratory test utilization ie to regulate laboratory testing so that beneficial testing is appropriately utilized and ineffective testing is curtailed. Unregulated laboratory testing has the potential to: a) increase system resource use, and b) facilitate overdiagnosis and overtreatment. In both senses unregulated laboratory testing contributes to the greatest healthcare threat of the century – declining Planetary Health. The pressure to grow our diagnostic tool capability, and to gather laboratory data, in the service of precision medicine, is high. However, precision medicine is dependent on Planetary Health – therefore, the former must not hinder the latter. Guiding diagnostic care in this era of precision medicine and the Code Red for humanity is a challenge for pathologists in all corners of the globe.