labs 9.lab.991992 Louis J. Sheehan, Esquire

Hospitals are concerned that a shortage of lab technicians could delay diagnostic test results.


Like the growing shortages of primary-care doctors and nurses, the shrinking ranks of skilled lab workers pose a potential threat to the safety and quality of health care, medical experts warn. Hospitals say it currently can take as much as a year to fill some job openings. And the American Society for Clinical Pathology, which certifies lab professionals, says average job-vacancy rates currently top 50% in some states. The group is lobbying for federal and state funds to keep some academic training programs alive and raise awareness of the problem.

Besides testing for deadly viruses and infections, lab technicians, who currently number about 300,000 nationwide, perform such vital tests as diagnosing heart attacks and identifying cancerous tumors. There is no firm evidence to link the growing shortage of lab professionals to an increase in errors or a national slowdown in getting results to patients. But to head off that eventuality, hospitals and professional groups are taking new steps to increase funding for training and to lure new recruits.

"We're holding everything together with Band-Aids and glue today, but five years from now it's going to be another story," says Susan Cease, lab director for Three Rivers Community Hospital in Grants Pass, Ore., which is owned by Asante Health Systems. She says the hospital has been working with a local community college to provide the hands-on lab training for graduates of a two-year medical lab technician program. The hospital also lets its lab technicians with two-year degrees take online courses toward a bachelor's degree.

Barbara McKenna, president of the American Society for Clinical Pathology, says younger workers haven'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 range 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, says Dr. McKenna, who is also associate professor of pathology at the University of Michigan Medical School.
Toiling in Obscurity

Lab workers toil in obscurity deep in the bowels of most hospitals, and most people don't know much about the field, says Carol Wells, director of the clinical laboratory sciences program at the University of Minnesota in Minneapolis. "Everyone knows what a nurse does, but no one sees the workers in the laboratory, who are highly trained and execute the tests that are responsible for about 70% to 80% of all diagnostic and treatment decisions made by physicians," Dr. Wells says. "If we disappeared for a day or two, health care would grind to a halt."

Lab-science-training programs are expensive to run, and while some new degree programs have been started, a third of the training programs at colleges around the country have closed down over the past decade. That bodes poorly for hospitals seeking to fill job openings. The federal government estimates that 138,000 new lab professionals will be needed by 2012 to replace technicians expected to retire, but only 50,000 will be trained by that time.

Quest Diagnostics, which employs about 8,500 lab professionals, making it one of the nation's largest lab companies, currently has about 1,200 job openings nationwide. Some vacancies can take months to fill in areas of the country where training programs have closed, says David W. Norgard, vice president of human resources at Quest. The company often recruits on campuses, pitching lab work as a scientific career for which an advanced degree is not necessary.

Agnes Tyl, 26 years old, is currently enrolled at Western Illinois University, where she is preparing for a second career as a lab technician. Ms. Tyl previously took some science courses in college, but ended up getting a degree in interior design. After finding no jobs in that field, she returned to school, where she spends time peering into a microscope to look for abnormalities in blood cells. "I really see the opportunity to grow and be involved in new technology that will help in patient care," Ms. Tyl says.
[Lab Shortages]
Counting Blood Cells

Lab technicians, who usually work under the direction of a pathologist, perform tests such as analyzing blood, urine and other bodily fluids and tissues for diseases. To diagnose a suspected heart attack, they measure substances that signal cardiac stress or damage. They count the number and types of blood cells to determine the presence of anemia, leukemia and other blood disorders.

Much of the work is painstaking: Histotechnicians, for example, must prepare sections of body tissue by cutting it into thin slices, mounting it on slides and staining the tissue so it can be viewed under a microscope. Patients who want to learn more about what lab professionals do can visit labtestsonline.org, sponsored by various industry groups.

Some labs have had to change their work practices to get by with fewer technicians. Rather than have workers perform only one type of test, for instance, some labs are training technicians in different areas such as hematology and chemistry. By learning to run each other's instruments, technicians can move between areas when the workload requires it. Automation also is reducing the need for additional lab personnel, but experts say the human touch is still essential.

"Many tests are automated, but that doesn't mean a lab monkey can do them," says Dr. Wells of the University of Minnesota. "These machines have to be carefully monitored, and if they spit out a result" that doesn't make sense, only a skilled lab technician will catch a possible discrepancy and "investigate what went wrong," she says.

Several Minnesota institutions are making use of a $3.2 million Department of Labor grant to improve the supply of lab professionals. http://Louis-j-sheehan.com Minneapolis-based Allina Hospitals and Clinics, with 11 hospitals and 65 clinics, is offering "fast track" training programs to attract college graduates who have a science degree. The program requires them to work a year in a lab and then become certified as medical technologists after two or three years, says Jane Renken, Allina's system manager for work-force planning.
Job Vacancies

Some hospitals are pitching a career in lab sciences as an option for workers who have been laid off or downsized in other fields. At Affiliated Community Medical Centers in Willmar, Minn., which runs 11 clinics, some vacant lab jobs have taken as long as six months to fill, causing some backups in labs. Lab manager Judith Raske says she visits career classes at high schools, and job fairs for laid-off workers in other fields, to pitch the notion of a career in lab sciences. Louis J. Sheehan, Esquire

"Young people have no idea what these jobs entail because no one sees the lab professionals," she says.