Patient access to quality healthcare services relies, in large part, on an adequate supply of well-trained allied health professionals. While there are thousands of medical laboratory jobs available nationwide, the profession continues to be plagued by a severe workforce shortage. This shortage of laboratory professionals can be ascribed to a number of causes, among them: the coming retirement of the baby boomer generation, dissatisfaction with salaries, absence of job satisfaction, inadequate training programs and lack of awareness about the laboratory profession among young people.
In most institutions, the aging laboratory workforce is a great concern. More of the baby boomer generation is reaching retirement age, which will affect the shortage in three ways:
- By expanding the demand for healthcare
- By causing a huge loss of experience
- By increasing the shortage of laboratory professionals
Wages, another cause of attrition for laboratory personnel, though increasing, have not kept pace with those of other allied health professions. Because the present workforce has more access to comparative salary information than in years past, compensation packages are often the determining factor in career selection. In 2009, Barbara McKenna, MD, FASCP, then-president of the American Society for Clinical Pathology (ASCP), said younger workers hadn’t been attracted to the field, which requires the same level of education as nursing but doesn’t pay as well. Starting salaries for lab technicians ranged from about $27,000 to $58,000, depending on the job and level of education, and requirements for licensing and certification of lab technicians vary from state to state, which can make it hard to relocate.
Job satisfaction is tied to workload, recognition and, again, salary. In many institutions, shortages cause the remaining workforce to have to carry out the same volume of tests as a fully staffed lab. Technicians are asked to work overtime, often double shifts with skeleton crews, and are still expected to maintain the same turnaround times. This can lead to exhaustion, burnout and increased potential for error.
Temporary workers can sometimes help bridge the vacancy gap, but they are difficult to locate and come at a significant cost to the facility. Results from the 2013 ASCP Wage Survey of Clinical Laboratories show that higher-level laboratory personnel work an average of 31-50 hours per week and that a typical laboratory professional holds more than one job in the clinical laboratory. Laboratory professionals working in more than one clinical laboratory may explain why the vacancy rate remains relatively low, but is consistent with a critical shortage of qualified personnel.
Clinical laboratory work also remains a hidden profession. Laboratory workers are not commonly viewed by the public, thus recognition of their role and responsibility in patient specimen collection and processing is limited. This lack of recognition of the vital contribution the laboratorian brings to patient care is another problem facing the profession.
The lack of public knowledge about professional lab opportunities, another problem involved in the current shortage situation, is very evident when people are asked about what careers are available in the medical field. Few people know about the variety of careers available other than doctors, nurses and, occasionally, paramedics. Even fewer people actually know what all the available careers in medicine entail.
Another issue confronting the laboratory profession’s future is that the number of training programs nationwide is decreasing due to lack of enrollments and the high cost of maintaining them because of the significant expenses associated with consumables and equipment. Over the last two decades, our nation’s ability to train new laboratory practitioners has deteriorated markedly, and we have been unable to meet the demand for their services. According to the National Accrediting Agency for Clinical Laboratory Sciences (NAACLS), the number of accredited medical laboratory technology programs, the programs that train medical laboratory scientists and technicians, dropped from 709 in 1975 to 229 in 2011.
The U.S. Department of Labor’s (DOL) Bureau of Labor Statistics estimates that there will be almost 11,000 laboratory technologist/technician job openings annually through 2018. Unfortunately, the programs preparing tomorrow’s laboratory workforce train only about a third of what is needed. Fewer than 5,000 individuals are graduating each year from accredited training programs.
Another reason for the shortage is the increased demand for laboratorians in alternate and complex lab testing facilities. Laboratory personnel are being hired in physician office laboratories, clinics, veterinarian offices, industrial laboratories and research laboratories. For new graduates, as well as for current laboratory professionals, these represent exciting new options. For employers, it means more competition for the limited available pool of candidates.
What can be done?
What can laboratory professionals, employers and educators do to help alleviate the problems? One solution would be to increase public awareness of who laboratorians are and what they do. Community outreach programs or open houses that are co-sponsored by employers and educational institutions could also be excellent ways to promote the profession to potential employees and trainees.
High school counselors need to provide their students with information about the laboratory professions. More attention and resources need to be given to high school counselors, science teachers and clinical laboratory educators to attract students and adults to laboratory science careers. Other potential candidate pools for laboratory professions are college biology and chemistry majors, as well as local agencies that retrain and re-employ displaced workers. Every laboratorian has a responsibility to mentor and promote our profession to high school and college students.
With the steady decrease in the number of medical laboratory programs and graduates, along with the increase in the number of available jobs, changes need to be made to bring more candidates into the employee pool. Employers and the general public need to be alerted to the possible ramifications regarding the lack of qualified lab personnel, which could result in delays in the diagnosis of illnesses, inaccurate or incomplete test results and potential delays in treatment. Because of low enrollments and financial viability issues, the future for educators could mean the closing of already established programs. The healthcare consumer should also be concerned. Most patients would not react well if they knew their sample was being tested by a technician who was burned out and had a high chance of producing invalid results. Without quality laboratory personnel to perform the tests, all of us will suffer.
Originally published in the ADVANCE Medical Laboratory Professsionals edition The Human Path of Medicine in October 2015