DATELINE—BIRMINGHAM, ENGLAND: Workforce issues in medical laboratories received special attention here at the 10th Annual Frontiers in Laboratory Medicine (FiLM) conference that ended last week. Probably the major concern going forward is how to attract, train, and sustain adequate numbers in the medical laboratory workforce.
Two speakers addressed medical laboratory workforce issues at a strategic level, with an overview about developments in the United Kingdom and the United States. Speaking about the United Kingdom was Professor Sue Hill, OBE, Ph.D., Chief Science Officer for the National Health Service. Speaking about the United States was Elissa Passiment, Ed.M., CLS (NCA), Executive Vice President, American Society of Clinical Laboratory Science (ASCLS).
Need for Well-Trained Medical Laboratory Professionals
Having the two perspectives presented in a side-by-side fashion allowed FiLM attendees to understand the differences and similarities in how each country has established goals to address the need for adequate numbers of well-trained laboratory scientists across all disciplines.
The laboratory staffing challenges facing the United Kingdom and the United States are virtually identical:
- A large proportion of pathologists, clinical biochemists, medical laboratory scientists and other lab scientists are reaching retirement age. This has two consequences. First, at each retirement, the laboratory loses a substantial amount of experience and institutional knowledge. Second, having many individuals retire from the laboratory within a certain time period can leave the laboratory short-staffed.
- Not enough training slots are available. This means that academic training programs cannot graduate the required numbers of laboratory scientists and pathologists to meet the demand.
- The technology and clinical practice in laboratory medicine is changing at an quickening pace—particularly in molecular diagnostics and genetic testing. Academic training programs for all types of medical laboratory scientists are lagging behind in incorporating these developments into their curriculums.
In their respective presentations, both Hill and Passiment pointed out that, in each of their countries, there is a lack of a clear career path in laboratory medicine for graduating students. This is a problem, because Generation Y, also called Millennials, are often careful career planners. The clinical laboratory profession is competing with other career choices.
Passiment described some of the drawbacks to a career in laboratory medicine that are mentioned by students as they consider career options.
- Individuals with disparate levels of practice and education performing the same tasks in a laboratory with similar compensation,
- Lack of a well-defined career ladder,
- Use of inadequately educated/trained individuals in the practice setting, and
- Underutilization of the MLS’s skills and education.
The United Kingdom responded to this situation by creating a task force. This team is working to create a more uniform structure for laboratory medicine scientists that recognizes different levels of education and experience in a consistent way—regardless of whether the practitioner is working in clinical chemistry, microbiology, histopathology, and related sciences in the lab. Hill described the framework that is emerging from this work in the United Kingdom.
In the United States, rationalizing the mélange of certifications and licensure requirements for medical laboratory professionals is more problematic. That’s because each of the 50 states establishes its own statutory requirements. Passiment shared the structure of a recommended career ladder that acknowledges educational training and experience. This was developed by a group of lab industry associations as something that could be used to guide legislative and other reform efforts.
In each nation, those lab medicine leaders actively working to revise and update a defined career path for laboratory medicine professionals must have a perspective on how clinical laboratory testing services will be organized and delivered in the future. Sue Hill offered a slide during her talk that reflects some thinking within the National Health Service on this point. Readers of Dark Daily in other nations may find this to be remarkably similar to the developments unfolding in their own country.
Here is the slide text from Hill’s presentation, which described the attributes that pathology and laboratory medicine will be expected to meet in coming years:
Establish a set of standards/principles for diagnostics
• Same day, one trip
• Available locally, e.g. near as a pharmacy
• Diagnostic modalities working together with shared skills
• Seven days a week service
• Linked to decision support
• IT compliant and integrated to care record
Distributed model of provision
• In the home
• Local “diagnostic hubs” (multi-modality and multi-functional)
• Support for acute hospital-based care (district level)
• Centres of specialist expertise
The most interesting part of this list is the “distributed model” of lab testing. These elements indicate and expectation that more patient self-testing will happen, along with increased opportunities to offer medical laboratory tests in settings that include pharmacies and stand-along diagnostic centers that offer imaging and other associated diagnostic services.
Challenges Ahead in Recruitment of Clinical Pathology Lab Staff
At the conclusion of her presentation, Passiment recognized the challenge that lies ahead in recruitment of young people to be medical laboratory scientists. “From the perspective of today’s student, laboratory medicine is seen as an invisible profession,” she explained. “There is no public recognition of what a medical laboratory scientist is and the type of work they perform. For example, among the general public, how many people understand what work is performed by an MT, a CLS, an MLS, or an MLT?
“This makes it more difficult for laboratories to attract and retain the Millennial Generation, since these young people cannot see an objective obvious career path, nor can they see how they would be valued,” she concluded.
As has been true in past years, the spectrum of presentations at this year’s Frontiers in Laboratory Medicine (FiLM) program make it easy to see that there are more similarities in laboratory medicine in the United States and the United Kingdom than there are differences. Further, the forces of change and reform to the healthcare system in each nation guarantee that clinical laboratories will have plenty of opportunities to deliver value to clinicians—but only if they remain nimble and change in response to these reforms.
From Birmingham, England,
Your Dark Daily Editor,
Robert L. Michel