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

Hosted by Robert Michel

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Clinical Laboratories and Pathology Groups

Hosted by Robert Michel
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Pathology Lab Shortages in New Zealand Are One Cause in Long Delays in Melanoma Diagnoses

Similar diagnostic delays due to clinical laboratory staff shortages are reported in other nations as well

Critical pathology shortages are causing lengthy delays for clinical laboratory test results in New Zealand, according to a report that states some patients are waiting over a month for a melanoma diagnosis. This situation puts the lives of cancer patients at risk in the island nation. 

The Melanoma Network of New Zealand (MelNet) is working to reduce the number of people who develop the disease and help melanoma patients receive a fast diagnosis and proper treatment and care.

However, plastic surgeon and MelNet Chair Gary Duncan, MBChB, FRACS, told Radio New Zealand (RNZ) that when patients return to their doctors for test results, those results often have not come back from the medical laboratory. Therefore, the physician cannot discuss any issues with the patient, which causes them to make another appointment for a later date or receive a melanoma diagnosis over the telephone, RNZ reported.

Dermatologist Louise Reiche, MBChB, FRACS, told RNZ that slow pathology services are unfair to patients. Such delays could result in the spreading of the melanoma to other parts of the body and require major surgery under anesthetic.

“Not only will they suffer an extensive surgical procedure, but it could also shorten their life,” she said.

Trishe Leong, MB.BS (hons) Medicine, FRCPA Anatomical Pathology

“We’ve got shortages across the board, and it only seems to be getting worse,” said Trishe Leong, MB.BS (hons) Medicine, FRCPA Anatomical Pathology (above), President of the Royal College of Pathologists of Australasia (RCPA). She added that “there was also a backlog of pathological examinations of placentas, which are used to detect genetic conditions and shed light on complex births,” The Sydney Morning Herald reported. Clinical laboratories in several countries worldwide are experiencing similar delays in reporting critical test results to physicians and their patients. (Photo copyright: RCPA.)

Pathology Labs Cannot Meet Demand for Testing

The Royal College of Pathologists recommends that 80% of specimen results should be returned to clinicians within five days. General practitioner Jeremy Hay, MD, of the Upper Hutt Skin Clinic told RNZ that he has never seen a melanoma report returned from the laboratory he utilizes within the suggested five-day time span. He stated that his local pathology lab simply cannot meet the demand for the vast number of samples waiting to be tested.

“I have visited the lab, and you can see even in the corridors stacks of unreported slides sitting outside the pathologist’s rooms, and there are more inside their rooms,” he said. “They need more staff and that’s quite obvious.”

Hay added that, because of the delays, he typically does not start with a small biopsy of a suspicious-looking piece of skin. Instead, he just cuts the entire area out and sends it to the lab for testing to expedite the diagnosis process.

Lab Loses Accreditation Due to Delays

Long delays caused one lab—Auckland’s Community Anatomic Pathology Service (APS)—to lose its accreditation for the lab’s skin testing department. According to RNZ, some patients had to wait up to eight weeks to learn whether they had melanoma.

An article published by medical/science specialty recruiting firm Odyssey, states that the deficiency at APS was due to several factors, including:

  • Population growth.
  • An increase in private medical practices.
  • The underestimation of the costs required to run the lab.
  • An overestimation of potential savings.
  • A shortage of qualified pathologists, specifically in the fields of anatomical, chemical, and forensic pathology.

The article also states that pathologists are now listed on Immigration New Zealand’s list of shortage skills in the country. That designation means that foreign candidates who have the skills, and who are offered jobs in the country, can immediately apply for permanent residency. 

Three Week Wait for Cancer Diagnoses in Australia

According to the World Cancer Research Fund International (WCRF), New Zealand has the second highest rate of melanoma in the world. The number one spot is held by Australia. 

Other countries are experiencing long wait times for cancer diagnoses as well. According to The Sydney Morning Herald, some individuals are waiting up to three weeks to receive a cancer diagnosis due to a shortage of pathologists.

“It could be the cancer you didn’t suspect,” said Trishe Leong, MB.BS (hons) Medicine, FRCPA Anatomical Pathology, President of the Royal College of Pathologists of Australasia. “There’s always the chance of something unexpected showing up in a biopsy, and if that is not tended to as soon as possible it can have an impact on patient care.”

This is not the first time Dark Daily has reported on clinical laboratory staff shortages around the world causing huge test result delays.

In “Irish Cancer Society Report Shows Patients May Wait Two Years or More for Genetic Cancer Test Results,” we covered research conducted at the University of College Cork (UCC) which revealed that genetic services have been “starved of investment and resources” in the Emerald Isle, leaving healthcare workers involved in cancer genetics and follow-on services “completely overstretched.”   

And in “In Canada, Shortage of Medical Laboratory Technologists and Radiology Technicians Continues to Delay Care,” we reported how varies combinations of facility, physician, and other healthcare professional shortages are generating regular headlines about patient wait times in the UK, Canada, New Zealand, and Australia, particularly for elective procedures that may be six months to a year or more.

In those countries, and around the world, healthcare experts say the solution is expanding training opportunities to solve the shortage of clinical laboratory scientists, medical laboratory and imaging technologists, doctors, nurses, and other medical professionals, and increasing funding for modernizing hospital facilities and clinics.

But in countries with government-run healthcare, that solution is problematic at best.

—JP Schlingman

Related Information:

Eight-week Wait for Skin Cancer Test Results Risking Lives – Doctors

Private Healthcare Pushing Auckland Labs to the Brink

Factors Increasing Demand for Pathology Services in Auckland NZ

‘The Cancer You Didn’t Suspect’: Medical Test Delays Could Be Endangering Patients

Irish Cancer Society Report Shows Patients May Wait Two Years or More for Genetic Cancer Test Results

Critical Shortage of Pathologists in Africa Triggers Calls for More Training Programs and Incentives to Increase the Number of Skilled Histopathologists

A critical shortage of pathologists in southern Africa is hindering the ability of medical laboratories in the region to properly diagnose and classify diseases

Countries in the Southern Africa Development Community (SADC) are currently dealing with a severe scarcity of pathologists. More pathologists are needed in the region to examine samples and interpret medical laboratory tests in order to ensure patients receive proper treatment.

There are a total of fifteen countries in SADC: Angola, Botswana, Democratic Republic of the Congo, Lesotho, Madagascar, Malawi, Mauritius, Mozambique, Namibia, Seychelles, South Africa, Swaziland, Tanzania, Zambia, and Zimbabwe.

Dark Daily has regularly written about the issues affecting medical laboratory testing in developing nations throughout the world. There are three challenges that are common to most of these countries: (more…)

British Health Authorities Criticize Medical Laboratory Tests for Consumers

It’s not just in the United States that Direct-to-Consumer (DTC) medical laboratory tests are coming under criticism, as reported in recent weeks by Dark Daily. Two prominent organizations in the United Kingdom (UK) have issued reports with serious criticisms of what are known as “Do-It-Yourself” (DIY) clinical laboratory tests in that country.

Researchers identified the several ways that DIY test in the UK, often bought over-the-counter in pharmacies, could mislead or harm consumers. In our earlier Dark Daily e-briefing titled “Medical Laboratory Tests for Consumers Under Investigation on Two Continents,” we presented pathologists and clinical laboratory managers with the results of a General Accountability Office (GAO) study that was critical of DTC medical laboratory tests.

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Medical Laboratory Tests for Consumers Under Investigation on Two Continents

Government agencies in both the United States and the United Kingdom look at direct-to-consumer (DTC) tests

Direct-to-Consumer (DTC) medical tests are under attack by multiple federal agencies here in the United States, even as authorities in the United Kingdom (UK) similarly question the potential of these genetic tests and molecular diagnostic assays to harm and/or mislead consumers.

Of course, many pathologists and clinical laboratory managers here in the United States know that multiple government agencies have spent the last year scrutinizing the DTC market. There is the possibility that new regulations and laws enacted as a result of these investigations could not only bring DTC genetic testing under tighter government oversight, but these same regulations might also ensnare certain genetic tests and medical laboratory assays that have appropriate uses in clinical care.

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