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.”
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.
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.
“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.
Influenza Outbreak Calls Attention to Shortage of Medical Technologists, other lab staff
It took the threat of an influenza pandemic recently to get at least one news reporter to realize the shortage of medical laboratory technicians has reached epidemic proportions.
While the recent outbreak of A/H1N1 influenza turned out to be a dress rehearsal, it inspired Wall Street Journal (WSJ) reporter Laura Landro to focus on the critical role played by medical technologists, clinical laboratory scientists, medical laboratory technicians, and other lab professionals, along with the potential consequences of this clinical laboratory staffing shortage when a killer bug turns out to be “for real.”
Vacancy rates in U.S. medical laboratories have declined since COVID-19 highs, but ASCP’s latest survey finds staffing levels remain well above pre-pandemic norms as retirements accelerate and recruitment challenges deepen.
The American Society for Clinical Pathology’s (ASCP) 2024 Vacancy Survey shows that staffing conditions inside U.S. medical laboratories have improved modestly since the peak of the COVID-19 pandemic but remain unresolved. Vacancy rates have declined compared with 2020–2022, yet they are still significantly higher than pre-pandemic levels, underscoring persistent recruitment and retention challenges that continue to affect laboratory operations nationwide.
Conducted every two years for the past 37 years, the ASCP Vacancy Survey is the most widely cited barometer of workforce conditions in laboratory medicine. The 2024 survey gathered responses from 1,027 laboratory leaders and human resources professionals, representing staffing data for 18,626 laboratory employees across the United States. Participants came from hospitals of all sizes, reference laboratories, academic medical centers, public health laboratories, blood centers, government facilities, and industry settings.
Retirements Accelerate as Workforce Recovery Remains Uneven
“Although vacancy rates are lower than those reported during the pandemic, laboratories are still operating under sustained workforce pressure,” the authors wrote. “The data suggest that recovery has been uneven and incomplete.”
Retirement trends emerged as a major concern. Ten of the 17 laboratory departments included in the survey reported rising retirement rates compared with previous cycles. As experienced professionals exit the workforce, laboratories face the dual challenge of replacing technical expertise while maintaining service levels amid already-elevated vacancy rates. Survey authors warned that retirements are accelerating faster than the pipeline of newly trained professionals entering the field.
AI Readiness and Workforce Gaps Vary Widely Across Laboratories
“Continued challenges in recruitment, combined with increasing retirements, pose a serious risk to long-term workforce stability,” the report stated. Without intervention, ASCP cautioned that shortages could deepen, particularly in highly specialized laboratory disciplines.
The survey also sheds light on how laboratory leaders are thinking about artificial intelligence. Respondents most frequently cited “adapting to emerging technologies” as their top concern related to AI adoption.
However, enthusiasm for AI’s potential to transform laboratory operations remains strong. Laboratories that had already implemented AI tools or provided AI training to staff reported significantly more optimism and confidence.
“Enthusiasm about AI was notably higher in laboratories that demonstrated AI proficiency among laboratory professionals and other experts,” the authors noted, suggesting that education and hands-on experience play a critical role in shaping perceptions of new technology.
Geographic and departmental trends further highlight workforce disparities. Blood bank and transfusion medicine departments accounted for the largest share of reported personnel, while flow cytometry represented the smallest. Regionally, the South Central Atlantic reported the highest participation, while the Central Southwest reported the lowest. The states with the most respondents were New York, Florida, Texas, Pennsylvania, and California.
Testing volumes varied widely. Nearly 40% of respondents reported performing more than 100,000 clinical pathology tests annually, while fewer than one in five laboratories reported anatomic pathology volumes exceeding 50,000 cases per year, reflecting the diverse operational scales represented in the data.
New Analytics Underscore Urgent Need for Laboratory Workforce Advocacy
The 2024 survey also marked a methodological shift. ASCP transitioned its analysis from traditional statistical software to Python-based data processing, allowing for more flexible analysis and integration of qualitative feedback. According to the authors, this change enhances reproducibility and aligns the survey with modern data-science practices increasingly used in healthcare analytics.
Ultimately, the report calls for urgent, coordinated action. ASCP emphasized the need for stronger advocacy for laboratory professionals, expanded credentialing pathways, and increased investment in education and training programs. “There is an urgent need for advocacy on behalf of laboratory professionals and an increase in the number of laboratory education and training programs,” the authors stated.
For laboratory executives and pathologists, the message is clear: while the worst of the pandemic staffing crisis may be over, structural workforce challenges remain unresolved and without sustained attention, they threaten the long-term resilience of the nation’s diagnostic infrastructure.
Intraoperative frozen section (IFS) consultation and rapid on-site evaluation (ROSE) are vital diagnostic pathology tools, enabling real-time decision-making that directly impacts patient outcomes. However, pathology departments are under unprecedented strain – the global shortage of pathologists is growing, with many nearing retirement age and fewer new pathologists entering the field. The result is overextended professionals, delayed diagnoses, and potential declines in the quality of patient care.
New AI tool doubled efficiency in busy university radiology department
Creative artificial intelligence (AI) solutions are being developed to address critical staffing shortages in radiology that could help with similar shortages in overworked pathology and clinical laboratories as well.
In a recent clinical study at 11-hospital Northwestern Medicine, researchers developed a new generative AI radiology tool to assist radiologists that demonstrates high accuracy and efficiency rates when working with multiple types of imaging scans.
For the study, approximately 24,000 radiology reports were analyzed and then compared for clinical accuracy with and without the AI tool. The tool evaluates an entire scan and generates a report that is 95% complete and personalized to each patient. A template based on that report is then provided to radiologists for review, according to a Northwestern Medicine Feinberg School of Medicine news release.
The study reported an average 15.5% increase in radiograph efficiency without compromising accuracy. Some radiologists even produced gains as high as 40%. The radiology reports were scrutinized during a five-month period last year and enabled radiologists to improve the time it took to return a diagnosis.
“This is, to my knowledge, the first use of AI that demonstrably improves productivity, especially in healthcare. Even in other fields, I haven’t seen anything close to a 40% boost,” said the study’s senior author Mozziyar Etemadi, MD, PhD, assistant professor of anesthesiology and biomedical engineering at Northwestern University McCormick School of Engineering, in the news release. (Photo copyright: Northwestern University.)
Doubled Efficiency for One Radiology Team
“For me and my colleagues, it’s not an exaggeration to say that it doubled our efficiency. It’s such a tremendous advantage and force multiplier,” said study co-author Samir Abboud, MD, emergency radiology in the department of radiology at Northwestern Medicine, in the news release.
“Having a draft report available, even before it is viewed by the radiologist, offers a simple, actionable datapoint that can be quickly and efficiently acted upon” added study senior author Mozziyar Etemadi, MD, PhD, assistant professor of anesthesiology and biomedical engineering at Northwestern University McCormick School of Engineering, in the news release. “This is completely different than traditional triage systems, which need to meticulously be trained one by one on each and every diagnosis.”
The AI tool can also alert radiologists to life-threatening conditions.
“On any given day in the ER, we might have 100 images to review, and we don’t know which one holds a diagnosis that could save a life,” Abboud said. “This technology helps us triage faster—so we catch the most urgent cases sooner and get patients to treatment quicker.”
Relying on In-house Data
Engineers at Northwestern developed the AI model using clinical data within the university’s own network, emphasizing that such tools can be created without assistance from other organizations.
“Our study shows that building custom AI models is well within reach of a typical health system, without reliance on expensive and opaque third-party tools like ChatGPT,” Etemadi noted.
The Journal of the American College of Radiology states the supply of radiologists is expected to increase by approximately 26% over the next 30 years. However, the need for radiologists is expected to grow between 17% and 27% over the same period. Becker’s Hospital Review reports there will be a shortage of up to 42,000 radiologists in the US by 2033.
Some health organizations are using a mixed model of permanent employees and contracted radiologists to meet the increasing demand for services. Others are also looking at options such as internal training programs, better benefits for workers, teleradiology, and remote radiologists to fulfill radiology needs.
“You still need a radiologist as the gold standard,” Abboud said. “Medicine changes constantly—new drugs, new devices, new diagnoses—and we have to make sure the AI keeps up. Our role becomes ensuring every interpretation is right for the patient.”
Can pathology practices and clinical laboratories learn from radiology’s situation? Development of AI solutions for those fields would likely have similar effects on workloads and overworked personnel.
Exploring the benefits of AI may be one way of helping meet clinical laboratory and pathology practice staff shortages.
