News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

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News, Analysis, Trends, Management Innovations for
Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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PwC Survey Finds 50% of Companies Plan Layoffs and 83% Intend to Move Forward with Streamlined Workforces

Amid cost pressures, healthcare providers also plan to cut staff though some jobs are plentiful; adequate staffing at medical laboratories continues to be a challenge

Thanks to the COVID-19 pandemic and subsequent “Great Resignation,” masses of people have left the workforce and companies large and small in all industries are struggling to retain employees. Clinical laboratories have been particularly hard hit with no relief in sight.

Now comes the results of a PricewaterhouseCoopers (PwC) survey which shows 50% of US companies in various industries—including major healthcare providers—plan to lay off employees. And 83% of organizations intend to move forward with a “streamlined workforce,” according to the latest PwC Pulse: Managing Business Risks in 2022 report.

How this will affect the workload on remaining hospital and medical laboratory staff is clear. And healthcare consumers may not take well to healthcare provides running leaner and with fewer staff than they currently do.

Nevertheless, the PwC survey results “illustrate the contradictory nature of today’s labor market, where skilled workers can still largely name their terms amid talent shortages even as companies look to let people go elsewhere,” Bloomberg wrote on the  CPA Practice Advisor website.

Bhushan Sethi

“Organizations are still walking a tightrope when it comes to talent as we begin to see the longer-term impacts of the ‘Great Resignation.’ Finding the proper balance between investing in specialized talent, managing headcount costs, and driving productivity and morale will remain a top focus,” said Bhushan Sethi (above), People and Organization Joint Global Leader at PwC and an adjunct professor at NYU Stern School of Business in a PwC news release. Clinical laboratories are finding it particularly challenging to fill staff positions across all areas of lab operations. (Photo copyright: PwC.)

Healthcare Has Biggest Challenges, says PwC

Clinical laboratory leaders and pathologist groups are well aware of the unique financial pressures on healthcare systems and medical labs, as well as shortages of pathologists, medical technologists, clinical laboratory scientists, information technology (IT) professionals, and other healthcare workers.

“Healthcare is seeing bigger talent challenges than other industries and is more focused on rehiring employees who have recently left,” the PwC report acknowledged. This is the second Pulse survey PwC conducted in 2022. The 722 respondents included leaders working in human capital and finance.  

Finding Right Talent, Focusing on Growth, Automation

Finding the right employees is so important to companies that PwC ranks “talent acquisition” as the second highest risk (38%) behind cyber-attacks (40%).

“Finding the right talent continues to be a challenge for business leaders,” PwC said. “After a frenzy of hiring and a tight labor market over the past few years, executives see the distinction between having people and having people with the right skills.”

Unlike the high-touch and personal nature of healthcare, industries such as consumer technology, media, and telecommunications can turn to automation to alleviate staffing struggles. And that is what nearly two-thirds, or 63%, of companies in those sectors, aim to do, PwC said.

Other survey talent findings:

  • 50% of companies plan layoffs.
  • 46% are dropping or eliminating sign-on bonuses.
  • 44% are rescinding job offers.

Conversely, the surveyed executives also told PwC they are “cautiously optimistic” and plan on growing and investing even as the economy gives mixed signals:

  • 83% of companies are focused on growth.
  • 70% plan an acquisition.
  • 53% aim to invest in digital transformation, 52% in IT, 49% in cybersecurity and privacy, and 48% in customer experience.

“After more than two years dealing with uncertainty related to the pandemic, business leaders recognize the urgent need to focus on growth in order to compete, and they’re zeroing in on what they can control,” PwC said.

New Remote Work Programs, Reduction in Real Estate Investing, Big Tech

Although companies report having more than enough physical office space, many (42%) have launched remote work programs:

  • 70% have expanded or plan to increase “permanent” remote work options as jobs permit.
  • 22% are reducing real estate investment (financial services and healthcare industries lead the way with 30% and 29%, respectively, saying real estate buys are cooling off).

“While companies continue to invest in many areas of the business, they’re scaling back the most in real estate and capex ex [capital expenditure]. After two years of remote work, many companies simply need less space, and they’re allocating capital accordingly,” the PwC report noted.

In a somewhat parallel release to PwC’s findings, news sources are reporting reductions in real estate and staff at high-profile Big Tech companies.

Meta Platforms, Inc. in Menlo Park, Calif. (formerly Facebook Inc.), is closing one of its New York offices and cutting back on plans to expand two other locations in the city, the Observer reported.

Business Insider reported, “More than 32,000 tech workers have been laid off in the US till July, including at Big Tech companies like Microsoft and Meta (formerly Facebook), and the worst has not been over yet for the tech sector that has seen massive stock sell-off.”

According to Forbes, “San Francisco-based electronic signature company DocuSign will lay off 9% of its more than 7,400 employees (roughly 670 employees), the company announced in a Securities and Exchange filing Wednesday, saying the cuts are ‘necessary to ensure we are capitalizing on our long-term opportunity and setting up the company for future success.’”

And Bloomberg recently reported that Intel is planning to layoff thousands of people “around the same time as its third-quarter earnings report on Oct. 27.”

Healthcare Providers Plan Layoffs, Seek IT Pros

Meanwhile, major healthcare provider networks also are planning staff cuts amid service closures, rising costs, and other issues, according to Becker’s Hospital Review:

“Our health system, like others around the nation, is facing significant financial pressures from historic inflation, rising pharmaceutical and labor costs, COVID-19, expiration of CARES Act funding, and reimbursement not proportional with expenses,” BHSH said in a statement shared with Becker’s.

Amidst these layoffs, however, IT jobs in healthcare seem to be growing. According to Becker’s Health IT, some healthcare providers have posted information technology openings:

So, though it appears IT positions continue to expand, clinical laboratory leaders and pathology practice managers may want to prepare now for dealing with customers’ response to leaner healthcare systems overall.

Donna Marie Pocius

Related Information:

PwC Pulse: Managing Business Risks in 2022

Layoffs are Being Planned at Half of US Companies, PwC Survey Shows

Business Executives Remain Bullish about Their Ability to Manage Turbulent Conditions, according to New PwC Survey

Meta Is Closing a Manhattan Office as It Consolidates Its New York City Presence

50% of Companies Planning Job Cuts Amid Economic Downturn: Report

Ascension to Close Hospital, Lay Off 133 Workers

Microsoft Reportedly Cuts Nearly 1,000 Employees—Here Are the Biggest US Layoffs This Year

Intel Is Planning Thousands of Job Cuts in Face of PC Slump

Hospitals Cut Jobs to Resuscitate Finances

IT Job Openings at Mayo, Northwell, CommonSpirit, and Providence

Proven Approaches to Clinical Laboratory Cost-Cutting and Effective Staff Recruitment/Retention to Be Shared at New Workshops in Chicago and Miami

Answers and effective solutions to the lab profession’s most urgent challenges will be front and center at the innovative ‘Lab Management Essentials Workshop’

Three powerful forces are slamming clinical laboratories today. One is the urgent need to cut costs. Second is the struggle to achieve and maintain full lab staffing. Third is the pressure to increase revenue and expand market share.

All of this is happening even as hospitals and health systems must deal with almost identical issues. Cost-cutting, recruiting more staff, and finding ways to increase revenue dominate the thoughts and actions of senior health administrators.

Most Hospitals and Health Systems Report Substantial Financial Losses

News reports about the financial losses at hospitals and health systems tell the story. For example, one report in Becker’s Healthcare described the financial damage at three major, multi-state health systems:

  • AdventHealth, a 48-hospital health system, reported a $417.7 million net loss in the first quarter of 2022. It reported that, because of inflation, costs had increased by 15% over prior year.
  • Kaiser Permanente, with 12.6 million members in seven regions of the United States, reported a net loss of $961 million in the first quarter of 2022. One major factor in these losses was the increase in expenses, which was 9.5%. For second quarter 2022, Kaiser Permanente showed a loss of $1.3 billion, most of that from a decline in the value of its investment portfolio.
  • Ascension Health, with 143 hospitals in 19 states, reported a net loss of $884.7 million in first quarter of 2022. It said its costs increased by 10.6% over the same period last year.

Most hospital-based clinical laboratory managers and pathologist are aware of these staggering financial losses. They also are watching how the shortage of nurses and other skilled personnel has hospitals scrambling to close that gap by paying more overtime, using temporary nurses who are paid at much higher rates, and increasing nurse salaries to prevent existing staff nurses from taking more lucrative offers from other hospitals in the community.

Clinical Laboratories Under Pressure to Cut Costs and Maintain Adequate Staff Levels

Hospital-based laboratories are on the frontline of these hurricane forces. Facing operating losses, hospitals ask their laboratories and other clinical service lines to cut costs below authorized budgets. Meanwhile, the labs themselves must deal with their own shortage of medical technologists (MTs) and clinical laboratory scientists (CLSs)—along with other skilled positions—that are required to provide the full menu of lab testing services.

This “perfect storm” of pressures to cut costs, keep staffing at authorized levels, and generate more revenue (that can offset rising costs of lab supplies and the higher salaries being paid to MTs and CLSs) is without precedent in the past four decades. To provide lab managers with the knowledge to resolve these challenges swiftly and confidently in their own laboratories, the team behind the Executive War College assembled experts to conduct a one-and-a-half-day interactive workshop.

The workshop is titled, Lab Management Essentials Workshop to Effectively Cut Costs, Improve Staff Hiring and Retention, and Generate More New Revenue. The first of these workshops will occur in Chicago on Oct. 20-21. The same instruction will be provided in a workshop in Miami on Nov. 10-11. By design, lab managers will learn in small settings that ensure personal interaction with the experts in lab cost cutting; staff recruiting, hiring, and retention; and generating more lab revenue.

Using Lab Case Studies to Teach Proven Solutions for Reducing Expenses

Each of the three important topics will be addressed in half-day learning modules. Following case study presentations on best practices, attendees at Lab Management Essentials will break out into smaller roundtable groups facilitated by lab industry experts. The groups will brainstorm how to apply these proven methods to cut costs, retain employees, and create revenue. They will then describe their findings to all participants.

Lab Management Essentials Workshop facilitators (clockwise from top left): Tafney Gunderson, Carlton Burgess, Dorothy Martin, Rick VanNess, Jane Hermansen, and Kim Zunker.

On the morning of day one, leaders of the lab cost-cutting module will be:

  • Carlton Burgess, Vice President of Laboratory Services at Prime Healthcare in Ontario, Calif.
  • Tafney Gunderson, Quality Systems Supervisor at Avera McKennan Laboratory in Sioux Falls, S.D.

On the afternoon of day one, leaders of the lab staff recruiting, hiring, and retention module will be:

  • Dorothy Martin, Regional Laboratory Manager at Dartmouth-Hitchcock Health in Lebanon, N.H.
  • Kim Zunker, MBA, MLS(ASCP), CAPM, Consulting Manager at Accumen in Scottsdale, Ariz.

On the morning of day two, leaders of the lab staff recruiting, hiring, and retention module will be:

  • Jane Hermansen, MBA, MT(ASCP), Manager of Outreach and Network Development at Mayo Clinic in Rochester, Minn.
  • Rick VanNess, Director of Product Management at Rhodes Group and TriCore Reference Laboratories in Albuquerque, N.M.

Delivering Essential Knowledge to Up-and-Coming Laboratory Managers

This Lab Management Essentials workshop is a first for the clinical laboratory profession. It brings together experienced, effective lab leaders to teach, guide, and coach your lab’s smartest up-and-coming lab managers. It accomplishes this in just one-and-a-half days, to minimize the time they are away from your lab.

To gain maximum benefits from this well-designed program, it is recommended that you send three or four of your front-line lab managers. Together, they will hear and learn at the same time, while working during the intimate sessions to identify the techniques and methods that will work best for your lab. This is important because, upon their return, they will have both enthusiasm and the knowledge to light the right fires under your lab staff and energize them into quickly deploying ways to slash expenses, attract top candidates to fill open positions, and even to tap new sources of revenue—all of which they learned during Lab Management Essentials.

Because the number of attendees to each workshop is limited, you are encouraged to click here to register yourself and your designated lab managers today.

—Robert Michel

Related Information:

Lab Workshop Solutions to Staffing, Cost Cutting, and Revenue Problems

Efficient Data Structure Can Bring in More Reimbursement Dollars and Allow Clinical Laboratories to Sell Aggregated Information

McKinsey and Company Report Offers Analysis and Insights on How Companies Can Deal with the Great Resignation Occurring in the US Labor Market

Recruiters should target five personas for hiring new talent and retaining existing staff, McKinsey says, a goal that would be challenging for clinical laboratories recruiting medical technologists

Clinical laboratories and pathology groups continue to struggle filling vacated positions with new hires and retaining adequate staff due to what has been dubbed the “Great Resignation.” The ongoing, pandemic-era phenomenon is seeing people leave their jobs in mass exodus and remains a characteristic of the 2022 labor market.

According to the US Department of Labor, 4.3 million people quit their jobs in January of this year. Of equal significance for hospital and health system medical laboratories with shrinking budgets, compensation rates are increasing for these positions at a steady pace.

This international economic trend continues to affect businesses across the country as workers leave their jobs in record numbers. Especially hard hit are hospitals and clinical laboratories, and recruiters seem at a loss as to what can be done to turn it around.

But a newly-released report, titled, “The Great Attrition Is Making Hiring Harder. Are You Searching the Right Talent Pools?” by global management consulting firm McKinsey and Company may help. The report offers insight and suggestions on how to attract and retain talented employees in a tight labor market.

Bonnie Dowling

“This isn’t just a passing trend, or a pandemic-related change to the labor market,” Bonnie Dowling (above), Associate Partner at McKinsey, told CNBC. “There’s been a fundamental shift in workers’ mentality, and their willingness to prioritize other things in their life beyond whatever job they hold. We’re never going back to how things were in 2019.” Clinical laboratory recruiters can attest to that statement as they continue to struggle to fill open positions and maintain staffing levels. (Photo copyright: McKinsey and Company.)

Workers Are Unhappy and Unsatisfied

For their report, McKinsey surveyed more than 12,000 workers located in the United States, Canada, United Kingdom, Australia, India, and Singapore to determine why they are resigning and what factors would sway them to remain in their positions.

Their findings suggest that 40% of the people in the workforce are unhappy and unsatisfied in their current jobs and are seeking better, more fulfilling employment opportunities. Among those workers who have recently resigned from a job, 41% said lack of opportunity for upward mobility and no pay or benefits was the top reason they quit.

The McKinsey analysts noted certain repetitive occurrences during the past year they attributed to the Great Resignation, which McKinsey calls the Great Attrition:

  • Reshuffling: Workers are resigning and taking positions in other industries, which is causing some industries to disproportionately lose talent.
  • Reinventing: Workers are vacating traditional employment and choosing nontraditional roles, such as temporary, gig, part-time work, or they are opting to start their own businesses. 
  • Reassessing: Workers are leaving the workforce entirely to focus on other priorities, such as taking care of children or relatives, concentrating on self-care, or pursuing other interests.

Recruiters Should Focus on Five Unique Personas

As of June 30, there were 10.7 million job openings in the US, according to US Bureau of Labor statistics. And some industries, such as healthcare, are losing talent to other industries.

Among surveyed individuals who quit their jobs between April 2020 and April 2022 in the healthcare and pharmaceutical industries, 54% accepted a position within another industry or did not return to the workforce, according to McKinsey analysts.

The McKinsey report urges hiring managers to focus on five unique personas in their efforts to target and hire desired talent, and retain them as employees:

  • Traditionalists: Career-oriented individuals who are the mainstay of the classic labor pool. They are easier to find through common recruitment strategies, according to McKinsey, and are motivated by compensation, benefits, job titles, status, and opportunities for career advancement.
  • Do-it-yourselfers: These workers are typically 25 to 45 years old and value flexibility above all else when choosing jobs. They want autonomy to establish their own hours and the type of duties they will perform. This includes gig, part-time, and self-employed workers as well as full-time employees in nontraditional roles.
  • Caregivers: Workers who are at home due to other priorities, but who may be looking for an opportunity to re-enter the workforce. People in this group desire companies that are willing to work around their personal schedules. They could be coaxed back into the labor force with part-time options, four-day work weeks, flexible hours, and work-at-home positions.
  • Idealists: These workers tend to be in the 18- to 24-year-old age range, may be working part-time, or may still be students. These individuals value being part of a community and are most easily swayed by companies that have a strong organizational culture with an emphasis on meaning and purpose.
  • Relaxers: People who are not looking for work, but who could be convinced to return to the labor force under ideal circumstances. This group is mostly comprised of early- and natural-age retirees who still have productive years left. They represent the largest percentage of the latent workforce, McKinsey noted. Companies should consider seeking out these seasoned workers who may be more interested in meaningful work than a big paycheck.

“More employers have opened up their aperture in order to meet the yawning talent gap that they’re facing,” said Bonnie Dowling, Associate Partner at McKinsey and one of the authors of the report in an interview with CNBC. “They’re prioritizing skills over educational background or previous job experience, which is creating more opportunities across sectors for job-seekers.” 

Four Strategies for Retaining Workers

Finally, the McKinsey report offered four strategies that companies can focus on to retain their existing talent and avoid resignations:

  • Sharpen traditional employee value status through compensation, benefits, career advancement potential, reputable job titles, and the overall prestige of the organization.
  • Build creative, nontraditional, value propositions revolving around flexibility, a strong company culture, and more personalized methods of career progression.
  • Expand and tailor talent-seeking approaches to woo nontraditional workers.
  • Invest in more meaning and belonging in the company’s culture to build stronger teams and relationships among workers.

“It’s everything from embedding flexibility in our credo to reassessing how we value our employees and provide them with the resources they need to do their job. All employers have the capacity to make these meaningful changes,” Dowling said. “But we have to start taking action, as opposed to sitting back and hoping that things are going to return to a ‘pre-pandemic norm’ because all signs point to the fact that they won’t.” 

The ongoing labor shortage is affecting many industries, but it has been especially hard on healthcare and clinical laboratories.

Clinical laboratory recruiters may want to begin looking at the shifting economic scene in the US as an opportunity to restructure workplaces and create a better model to avoid resignations and retain workers.

JP Schlingman

Related Information:

The Great Attrition is Making Hiring Harder. Are You Searching the Right Talent Pools?

The Top Reasons People Are Leaving Their Jobs Right Now, according to McKinsey. Hint: It’s Not All About Pay

“Great Attrition” or “Great Attraction”? The Choice is Yours

40% of Workers Are Considering Quitting Their Jobs Soon—Here’s Where They’re Going

Job Openings and Labor Turnover—June 2022

Clinical Laboratories Need Creative Staffing Strategies to Keep and Attract Hard-to-Find Medical Technologists, as Demand for COVID-19 Testing Increases

Kaufman Hall Study Concludes Operating Margins are Declining in Nation’s Hospitals and Health Systems during 2022, a finding with implications for Hospital Laboratories

Clinical laboratory managers and pathology group leaders may want to pay closer attention to shrinking hospital margins and whether this may put pressure on hospital laboratory budgets

Financial performance of the nation’s hospitals and health systems continues to disappoint hospital leaders. For the fourth consecutive month this year, hospital operating margins have remained in the red. This will, of course, affect the clinical laboratories and pathology departments at these institutions.

A recently released National Hospital Flash Report from healthcare management consulting firm Kaufman Hall indicates that 2022 has started off poorly for most healthcare organizations. The information in Kaufman’s report is based on data gathered from more than 900 hospitals and healthcare systems across the country.

The key takeaways outlined in the report for the month of April that are negatively affecting hospitals’ bottom lines include:

  • More patients are utilizing urgent care facilities, telemedicine options, and primary care providers instead of seeking care at hospital emergency departments.
  • Patients tend to be sicker, more expensive to treat, and require longer hospital stays compared to April of 2021.
  • Expenses remain high due to labor shortages, specialty supplies, supply chain issues, and costly pharmaceuticals.
Erik Swanson
 
“Labor shortages, high prices for supplies, and cost increases to treat sicker patients over longer stays are ballooning hospital expenses,” Erik Swanson (above), Senior Vice President of Data and Analytics for Kaufman Hall, told Fierce Healthcare. “With a bleak consensus outlook for the US economy, those factors and their effects could be here for a while.” Clinical laboratories have been grappling with supply and personnel shortages and rising costs for many years. (Photo copyright: Kaufman Hall.)

According to the report, the operating margins for the hospitals were down nearly 40% compared to March 2022 and declined 76% when compared to April 2021. The calculated median operating margin index was -3.09% throughout April 2022. In addition, operating earnings declined almost 27% from March to April of this year and 51.5% when contrasted with April of last year.

The report also found that patient volumes, average lengths of stays, and surgeries performed had declined overall during the month of April—but that hospital expenses rose during that period—thus decreasing profit margins. Total expenditures increased by 8.3% over April 2021, and 9.6% between March and April of this year.

Inflation, COVID-19 Key Factors in Hospitals’ First Quarter Losses

The report noted that the historic rise in inflation during the month of April is fueling negative revenues for healthcare systems and hospitals. Several for-profit and nonprofit hospital systems reported losses for the first quarter of 2022.

Kaufman’s report for the month of March was slightly more positive as the healthcare organizations surveyed reported an incremental rise in patient volumes and minor expense relief, resulting in gains in volumes and revenues. March also saw an increase in outpatient and surgery volumes and lower numbers of high-acuity patients. However, that slight upward trend did not last through April.

Another reason for the year-to-date unsatisfactory revenue margins for hospitals across the country was the surge of patients seeking care for the SARS-CoV-2 omicron variant of the COVID-19 infection earlier in the year.

“The first few months of this year were decimated by the impact of the omicron wave, but as the omicron wave subsided, we had a bit of a rebound in those volumes, and that’s what you saw in March,” Erik Swanson, Senior Vice President of Data and Analytics for Kaufman Hall told HealthLeaders. “However, it wasn’t a rebound to the full historical volumes, and that is again because of that wave.”

Healthcare Organizations are Advised to Look at Expenses

The National Hospital Flash Report is published monthly by Kaufman Hall and provides vital analyses and observations on the fiscal performance of hospitals and healthcare systems. The information contained in the report includes data on margins, volumes, revenues, and expenses.

“The revenue side is a bit more challenging for organizations to control. Many are looking at their internal revenue cycle, understanding where there can be improvements in their own process, improving just the performance of the revenue cycle that improves the collections rates,” Swanson said. “Many are also trying to renegotiate with payers and negotiate perhaps as aggressively as possible to get the best rates. But I think where you see much of the levers that organizations can pull is on the expense side.”

Fluctuations in revenue mean that organizations—including clinical laboratories—will have to establish new strategies to diminish their financial shortfalls.

“Finally, because a lot of these challenges are due to these ebbs and flows in volumes, many organizations are also looking to see how they can embrace more data-driven predictive type models to look at volumes and think about how they can optimize their workforce to better handle these ebbs and flows of volume,” Swanson added. “This very often includes thinking about the appropriate size of float pools, the number of times that you need to pay overtime versus hiring new individuals, so many organizations are taking those approaches to bend the cost curve. There are quite a few levers that organizations are pulling to bend this cost curve down to ultimately improve their margins overall.”

The most recent report concluded that the first four months of 2022 have been extremely challenging for hospitals and health systems with extended negative margins taking their toll. The report also projected that the overall picture does not look favorable for these organizations for the remainder of the year and that many healthcare facilities may finish out 2022 with substantially depressed margins.

Clinical laboratory managers and pathology group leaders serving hospital and integrated delivery networks (IDNs) may want to consider how these depressed hospital margins will affect their own laboratories. It may be timely to anticipate how this fall’s budget-planning cycle might require their labs to specify how costs can be cut in the coming budget year.

JP Schlingman

Related Information:

Hospitals Off to a Poor Financial Start in 2022

Kaufman Hall: Hospitals Face 4th Straight Month of Declining Operating Margins

National Hospital Flash Report: May 2022

National Hospital Flash Report: April 2022

National Hospital Flash Report: March 2022

National Hospital Flash Report: February 2022

Despite March Rebound, Hospital Revenues See Drastic Drop in April

That Giant Sucking Sound: Lost Patient Volume

Forbes Senior Contributor Covers Reasons for Growing Staff Shortages at Medical Laboratories and Possible Solutions

Factors contributing to shortage of med techs and other lab scientists include limited training programs in clinical laboratory science, pay disparity, and staff retention, notes infectious disease specialist Judy Stone, MD

Staff shortages are a growing challenge for medical laboratories, and now the problem has grabbed the attention of a major media outlet.

In a story she penned for Forbes, titled, “We’re Facing a Critical Shortage of Medical Laboratory Professionals,” senior contributor and infectious disease specialist Judy Stone, MD, wrote, “Behind the scenes at every hospital are indispensable medical laboratory professionals. They performed an estimated 13 billion laboratory tests in the United States each year before COVID. Since the pandemic began, they have also conducted almost 997 million diagnostic tests for COVID-19. The accuracy and timeliness of lab tests are critically important, as they shape approximately two-thirds of all medical decisions made by physicians.”

Stone was citing data from the US Bureau of Labor Statistics.

Though Stone states in her Forbes article that clinical laboratories in both the US and Canada are facing staff shortages, she notes that the problem is more acute in the US.

As Dark Daily reported in February, the so-called “Great Resignation” caused by the COVID-19 pandemic has had a severe impact on clinical laboratory staffs, creating shortages of pathologists as well as of medical technologists, medical laboratory technicians, and other lab scientists who are vital to the nation’s network of clinical laboratories.

In her analysis, however, Stone accurately observes that the problem pre-dates the pandemic. For examples she cites two surveys conducted in 2018 by the American Society for Clinical Pathology (ASCP):

Many pathologists and clinical laboratory managers would agree that Stone is right. Dark Daily has repeatedly reported on growing staff shortages at clinical laboratories worldwide.

In “Critical Shortages of Supplies and Qualified Personnel During the COVID-19 Pandemic is Taking a Toll on the Nation’s Clinical Laboratories says CAP,” Dark Daily reported on presentations given during the 2021 College of American Pathologists (CAP) virtual meeting in which presenters discussed the ever-increasing demand for COVID-19 testing that had placed an enormous amount of stress on clinical laboratories, medical technologists (MTs), and clinical laboratory scientists (CLSs) responsible for processing the high volume of SARS-CoV-2 tests, and on the supply chains medical laboratories depend on to receive and maintain adequate supplies of testing materials.

And in “Lab Staffing Shortages Reaching Dire Levels,” Dark Daily’s sister publication, The Dark Report, noted that CAP Today had characterized the current lab staffing shortage as going “from simmer to rolling boil” and that demand for medical technologists and other certified laboratory scientists far exceeds the supply. Consequently, many labs now use overtime and temp workers to handle daily testing, a strategy that has led to staff burnout and more turnover.

Judy Stone, MD
“There is a critical shortage of medical laboratory professionals in the US, and in Canada to a lesser extent,” wrote infectious disease specialist Judy Stone, MD (above), in an article she penned for Forbes. “Here [in the US],” she added, “we are 20-25,000 short on staff, with only 337,800 practicing. That is roughly one medical laboratory scientist per 1,000 people.” Clinical laboratories are well aware of the problem. A solution to solve it and return labs to former staffing levels is proving elusive. (Photo copyright: Forbes.)

Why the Shortfall?

In her Forbes article, Stone notes the following as factors behind the shortages:

  • Decline in training programs. “There are only [approximately] 240 medical laboratory technician and scientist training programs in the US, a 7% drop from 2000,” Stone wrote, adding that some states have no training programs at all. She notes that lab technicians must have a two-year associate degree while it takes an average of five years of post-secondary education to obtain a lab science degree.
  • Pay disparities. Citing data from the ASCP, Stone wrote that “medical lab professionals are paid 40%-60% less than nurses, physical therapists, or pharmacists.” Moreover, given the high cost of training, “many don’t feel the salary is worth the high investment,” she added.
  • Staff retention. In the ASCP’s 2018 job satisfaction survey, 85.3% of respondents reported burnout from their jobs, 36.5% cited problems with inadequate staffing, and nearly that many complained that workloads were too high.
  • Inconsistent licensing requirements. These requirements “are different from state to state,” Stone wrote. For example, the American Society for Clinical Laboratory Science (ASCLS) notes that 11 states plus Puerto Rico mandate licensure of laboratory personnel whereas others do not. Each of those states has specific licensing requirements, and while most offer reciprocity for other state licenses, “California [for example] does not recognize any certification or any other state license.”

In a 2018 report, “Addressing the Clinical Laboratory Workforce Shortage,” the ASCLS cited other factors contributing to the shortages, including retirement of aging personnel and increased demand for lab services.

Possible Solutions

Stone suggested the following remedies:

  • Improve working conditions. “We need to reduce the stress and workload of the lab professionals before we reach a greater crisis,” Stone wrote.
  • Standardize state certification. This will facilitate “mobility of staff and flexibility in responding to needs,” Stone suggested.
  • Improve education and training opportunities. The ASCLS has called for clinical lab science to be included in the Title VII health professions program, which provides funding for healthcare training. Rodney Rohde, PhD, a clinical laboratory science professor at Texas State University, “also suggests outreach to middle and high school STEM programs, to familiarize students early with career opportunities in the medical laboratory profession,” Stone wrote.
  • Recruit foreign workers. Stone suggested this as an interim solution, with programs to help them acclimate to practice standards in the US.

It will likely take multiple solutions like these to address the Great Resignation and bring the nation’s clinical laboratory staffing levels back to full. In the meantime, across the nation, a majority of clinical laboratories and anatomic pathology groups operate short-staffed and use overtime and temporary workers as a partial answer to their staffing requirements.

Stephen Beale

Related Information:

We’re Facing a Critical Shortage of Medical Laboratory Professionals

Our Lab Testing Capacity Is Getting Dangerously Low

Addressing the Clinical Laboratory Workforce Shortage

What You Need to Know about Working as a Lab Professional in a Different State

The American Society for Clinical Pathology’s Job Satisfaction, Well-Being, and Burnout Survey of Laboratory Professionals

The American Society for Clinical Pathology’s 2018 Vacancy Survey of Medical Laboratories in the United States

Critical Shortages of Supplies and Qualified Personnel During the COVID-19 Pandemic is Taking a Toll on the Nation’s Clinical Laboratories says CAP

Lab Staffing Shortages Reaching Dire Levels

Four Thousand New Zealand Medical Laboratory Scientists and Technicians Threatened to Strike over Low Pay and Poor Working Conditions

Last-minute court injunction stopped a mass walkout, but allied health workers continue to push country’s District Health Boards for improvements

In New Zealand, the unprecedented surge in PCR COVID-19 testing due to the SARS-CoV-2 Omicron variant appears to have pushed the country’s 10,000 healthcare workers—including 4,000 medical laboratory scientists and technicians—to the breaking point.

On March 3, just 24 hours before the first of two walkouts was scheduled to begin, New Zealand’s Employment Court banned the strike that would have shut down medical laboratories in the country’s mixed public-private healthcare system. Medical laboratory workers make up 40% of the nation’s 10,000 healthcare workers who planned the nationwide strike to protest low pay and poor working conditions, according to 1News.

“COVID was the perfect storm for the profile of laboratories and how undervalued they have been for far too long,” said medical laboratory scientist Terry Taylor, president of the New Zealand Institute of Medical Laboratory Science (NZIMLS).

Judge Issues Injunction Restraining the Strike

New Zealand’s Public Service Association (PSA) is the country’s largest trade union representing more than 80,000 workers across government, state-owned enterprises, local councils, health boards, and community groups.

The PSA’s 10,000 health workers (which includes 4,000 medical laboratory workers) had planned to strike on March 4-5 and March 18-19, but, according to the New Zealand Herald the Employment Court stopped the walkouts due to the rise in COVID-19-related hospitalizations.

The Herald noted, however, that PSA union members in Auckland had already postponed their walkout after county District Health Boards (DHB) expressed concern over patient safety.

“Striking has always been our last resort, and our members in Auckland continue to demonstrate their commitment to providing quality healthcare to New Zealanders by working tomorrow,” PSA Organizer Will Matthews told the Herald.

He insisted, however, that DHBs need to respond to workers’ concerns. “The depth of feeling from our members, and the support for industrial action nationwide is unprecedented,” Matthews told 1News. “We are now in a position where strike action is our only remaining option to get the DHBs and the government to listen.”

Terry Taylor
In an interview with Stuff, medical laboratory scientist Terry Taylor (above), president of the New Zealand Institute of Medical Laboratory Science, acknowledged laboratory workers’ commitment to doing the work, but he is concerned about the next big testing surge. “Goodwill only goes a certain distance in the end when people are knackered and not getting what they need. At the moment, we have the capability to do 50,000 to 60,000 [tests] per day throughout the whole country, but we couldn’t run that for more than a week. We’d be dead, we’d be overrun,” he said. Clinical laboratory leaders in this country may want to make note of Taylor’s concerns, as laboratory conditions in this country become stressed as well. (Photo copyright: Newshub.)

Clinical Laboratory Workers Claim Low Wages, Poor Conditions, Irrelevant Testing

While no new strike dates have been set, Matthews said striking workers would include contact tracers and laboratory staff as well as nearly 70 other groups of healthcare workers, many of whom “don’t even earn a living wage.” According to Peoples Dispatch, allied health workers are working under the terms of a contract that expired in 2020.

The starting salary for a DHB medical laboratory scientist after completing a four-year degree is NZ$56,773 (US$39,519), while lab assistants and technicians start out at less than NZ$50,000 (US$34,804), Stuff reported.

In an interview with 1News, Taylor maintained that diagnostic labs in New Zealand have long been understaffed, undervalued, and their workers poorly treated. The COVID-19 pandemic, he says, has exacerbated an ongoing problem. Issues such as space constraints, for example, have become even more problematic.

“We’ve got extra machinery that’s come into the labs, we don’t get any more space, all these consumables sitting all over hallways and corridors, extra staff coming in to do the stuff,” Taylor told RNZ. “So, we’ve lost all our tearooms, we’ve lost all our office space, our conditions are markedly less than they should be.”

1News points out that the country’s medical laboratory scientists and technicians are processing more than 20,000 PCR COVID-19 tests per day in addition to running 120,000 other samples and 200,000 diagnostic tests. At the end of March 2020, the average number of COVID-19 tests processed per day was 1,777.

While New Zealand has preached to its citizens the need for widespread PCR testing, Taylor argued in February 2022 that the country must change its approach to offering PCR testing only to symptomatic individuals and close contacts.

“To run our diagnostic laboratories into the ground with endless irrelevant testing is a direct reflection of poor foresight, planning, and respect for the role of this critical health workforce,” Taylor told Newshub.

Necessity of Rewarding All Medical Laboratory Personnel

Medical laboratory scientist Bryan Raill is president of Apex, a specialist union of allied, scientific and technical employees. Raill told 1News the long-term solution is for the government to address pay equity, staffing levels, and worker wellbeing in the country’s historically undervalued medical laboratories.

“Medical laboratory scientists and technicians have to be fairly rewarded for the training, skill, and expertise they bring to the health system,” Raill said. “Medical laboratory scientists need a timely, fair, and equitable process to determine their worth.”

While the stresses on New Zealand medical laboratory workers are not identical, US clinical laboratory leaders will want to monitor the lengths to which New Zealand’s laboratory workers are willing to go to force improvements in their working conditions, staffing, and pay.

As the noted above, the government-funded health system is continually strapped for funds. Consequently, the health districts often defer capital investment in hospitals and medical laboratories. That is one reason why lab staff can find themselves working in space that is inadequate for the volume of specimens which need to be tested daily.

Andrea Downing Peck

Related Information:

Why the ‘Hidden Heroes’ of Our COVID-19 Response Are Striking

COVID-19 Omicron Outbreak: Health Strike Postponed after Employment Court Grants Injunction

New Zealand Employment Court Passes Injunction to Scuttle Health Workers’ Strike

10,000 Health Workers Strike as Omicron Wave Hits

After almost Six Million Tests, an Omicron Explosion Will Heap More Stress on Exhausted Laboratory Workers

Burnt Out Laboratory Staff Working in Poor Conditions, Institute Says

COVID-19: PCR Testing Reaches ‘Crisis’ Point, Public Health and Lab Staff Plea for Symptomatic Testing Only

Pathology Laboratory Consolidation May Leave New Zealand Holiday Destinations with Limited COVID-19 Testing Capacity as Omicron Variant Arrives

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