Editorial by Rodney E. Rohde, Ph.D
April 24, 2016 marks the kick-off of National Medical Laboratory Professionals Week (#MLPW #LabWeek #Lab4Life). But, I often wonder if my friends, family, the general public, and even my other healthcare colleagues understand what it is we do and why we matter to your health.
What We Do
Have you ever wondered who conducts the detailed laboratory testing for your annual exam (such as cholesterol and glucose levels) and analyzes the results? Or, who conducts specialized testing for genetic disorders like sickle cell disease? How about those who identify an antibiotic resistant infection like Methicillin Resistant Staphylococcus aureus (MRSA) and determine which antibiotic is required to save someone’s life? Well, if you thought that it was your physician, or perhaps a nurse or someone else you see at your doctor’s office or in the hospital, you would be incorrect.
When I ask almost anyone in the general public who we are (medical laboratorians) and what we do, they typically don’t know the answer. Since we are often doing your important and critical medical laboratory work, you do not see us in the immediate healthcare environment (bedside, family physician office, etc.). You see the physician, the nurse, the respiratory therapist, the physical therapist and others. These healthcare professionals may even take blood from you or other types of specimens for analysis. However, most people do not know what happens to their specimens (blood, sputum, urine, etc.) once they arrive in the laboratory. They don’t know that medical laboratory professionals will conduct some of the most complex and important work on those specimens, and that knowing the results of that work may very well save your life.
Medical laboratory professionals provide up to 70 percent of the medical laboratory results/data for physicians and others to make informed decisions about one’s diagnosis and treatment plan. Here are just a few (very few) of the important types of testing we conduct:
- We type and match blood during emergency and routine surgery.
- We provide life-saving diagnoses regarding genetic disorders, healthcare associated infections (HAIs) such as MRSA and C.difficile. Medical laboratory professionals provide answers to life-and-death decisions every day.
- We detect sickle cell disease, as well as diagnose and monitor your cancer or diabetes results.
According to a 2002 study in Clinical Leadership and Management Review titled “The Value of the Laboratory Professional in the Continuum of Care,” author Rodney Forsman, Administrative Director Emeritus of the Mayo Clinic Medical Laboratories and President of the Clinical Laboratory Management Association, stated that 94 percent of the objective medical data in the patient record comes from the laboratory professionals. Doctors rely on laboratory test results to make informed patient diagnoses. Patient history along with physical signs and symptoms are vital, but most diagnoses need confirmation that only laboratory tests can provide. The laboratory professionals also contribute to wellness testing, guiding treatment, and monitoring patient progress.
While we should always support those in the public health trenches during times of emerging infectious disease like Ebola or the current Zika outbreak, everyone needs to be aware that professionals in the medical laboratories across this great state and country are JUST as important. We see the acute, immediate crisis in patient’s laboratory needs from these outbreaks in your emergency rooms and hospitals. You might consider us the front door of healthcare in regards to patient diagnosis, while public health laboratory professionals are working at confirming those initial results, as well as determining the epidemiological story behind an outbreak – usually when the event has been ongoing. I’ve worked in both professions, so I know by experience. Regardless, BOTH types of professionals are important to the overall public health of our population.
Critical Need for Medical Laboratory Professionals
Our profession is at a critical crossroads of employee shortages. In fact, we are probably facing far more shortages than most other healthcare careers (e.g. nurses) due to a number of factors. Employment of healthcare occupations is projected to grow 19 percent from 2014 to 2024, much faster than the average for all occupations, adding about 2.3 million new jobs. According to the Bureau of Labor Statistics, this growth is expected due to an aging population and because federal health insurance reform should increase the number of individuals who have access to health insurance. No surprise, right? Well, the difference for our profession is that we have long been hidden in the eyes of junior high and high school advisors, as well to counselors who advise students about college majors or career paths. This upstream problem of non-recognition with little advising at the pre-college level, coupled with the downstream problem of not being “seen” by patients and family members has an antagonistic (downward spiral) effect for growing our professional numbers. I, and many others, believe this is one of the most serious issues facing our profession.
we have long been hidden in the eyes of junior high and high school advisors, as well to counselors who advise students about college majors or career paths
Many students in middle school, junior high, and high school that love science are most often only steered towards medical school or nursing, or they are told to major in biology or chemistry or STEM. While these are all great choices, students in those environments, as well those in their early college years, are not always advised about the profession of medical (or clinical) laboratory science. Students wishing to pursue this career can choose from a four-year bachelor’s degree in medical laboratory science (MLS), an associate’s degree (two-year) as a medical laboratory technician (MLT), or even specialist / categorical areas alone (e.g. Immunology, I or a Specialist in Microbiology, SM). Each of these routes still enables a student to consider medical school, physician assistant, pathologist assistant, or other medical roles, as well as specializing in other areas, like microbiology, education and industry. Indeed, we believe that a major in the field of medical laboratory science makes for an even more astute physician or other healthcare professional, one that would truly understand the laboratory tests being ordered, and why they should be ordered. As I, and many of my colleagues in academia and the workforce know, not every student is going to end up in medical school or become a nurse. If these students understood that the amazing laboratory medicine profession has an actual college major, then perhaps they could leverage that love for science and investigation into a career as a medical laboratory professional.
Formal coursework training in medical laboratory testing comprises a small portion of the curriculum for physicians, nurses, pharmacists, physical therapists, occupational therapists, and biology graduates. However, for MLS and MLT students, medical laboratory theory for all 1,000+ available lab tests, sources of interference, and connections between test results and diagnoses is the main focus of their studies. We are the professionals that conduct the critical quality control that ensures your results are correct.
Texas is fortunate. We have 14 accredited bachelor-level Medical Laboratory Science (MLS) programs and 20 accredited associate-level Medical Laboratory Technician (MLT) programs. We have more accredited programs than the similarly sized states of California and Florida. Some states need licensure to assist in the promotion of the profession and implementation of new MLS or MLT programs. Our professionals are also asked to become certified or licensed via a board exam after graduation from a NAACLS approved MLS or MLT program or via a work route. Texas has the infrastructure to educate adequate numbers of qualified laboratorians; however, some of these programs are in jeopardy.
Nationally, there are approximately 2,600 MLS and 2,300 MLT students graduating each year, creating a total of 4,900 new personnel to fill over 9,100 job openings – resulting in a 46% vacancy rate. In Texas, there are about 225 MLS graduates and 200 MLT graduates to fill 985 jobs, leaving 57 percent of the jobs unfilled. To address growing concerns about the shortages of health professionals across the state, the Statewide Health Coordinating Council (SHCC) created the report 2011-2016 Texas State Health Plan: A Roadmap to a Healthy Texas (Pages 89-90 addresses licensure and shortages of laboratory professionals).
We are in a growing crisis of shortages of both medical laboratory and public health professionals
During the recent and now past Ebola crisis, who do you think did the initial testing of those specimens? And currently, we have the ongoing Zika virus threat. We are in a growing crisis of shortages of both medical laboratory and public health professionals. We are not prepared in the medical laboratory or public health community to meet these threats. And believe me, they will keep coming. HAIs, diabetes, cancer and other threats to our health do not care about the shortages of these laboratory professionals, but you should!
I, and my colleagues, hope that you will begin to share exactly who we are and what we do. Simply put, WE SAVE LIVES EVERYDAY. You may not see us or know us, but you want us at the medical laboratory bench matching your blood or diagnosing your cancer. Take a moment to watch this video and find out WHY we need this type of support now, not later.
Get on the right side of this issue. Please, help us before the health of another person is put in jeopardy.
Chair & Professor, Texas State University, Clinical Laboratory Science Program
Associate Dean for Research, College of Health Professions
Associate Adjunct Professor of Biology, Austin Community College
President, Texas Association for Clinical Laboratory Science (TACLS) – 2015-2017
Rodney E. Rohde, Ph.D, is the President of the Texas Association for Clinical Laboratory Science (TACLS), as well as Chair and Professor of the Clinical Laboratory Science program at Texas State University. His article, “The hidden profession that saves lives” appeared in the open-access online Elsevier Connect post, February 11, 2014 via https://www.elsevier.com/connect/the-hidden-profession-that-saves-lives and has over 250,000 shares!!
**For any verification of data or statements, see the link to the published Elsevier connect article.