CEO SUMMARY: Just weeks ago, CAP Today characterized the current crisis in staffing clinical laboratories as going “from simmer to rolling boil.” 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. But that is a strategy that leads to staff burnout and more turnover. It may be that yet-to-exist automation will be the ultimate answer.
Throughout the two-plus years of the COVID-19 pandemic, clinical laboratories struggled to adequately staff all types of positions. Today, as the pandemic eases, lab staffing shortages continue and is the number one issue at a majority of the nation’s labs and pathology groups.
The nature of this dire situation was best described by writer Anne Paxton. In a story in this month’s issue of CAP Today, titled, “Lab Workforce Crisis Takes Top Spot,” her lead paragraph states:
April 2022—There are sudden crises like the SARS-CoV-2 pandemic. And then there are the simmering crises that can be temporarily overshadowed but inevitably re-emerge to command notice. In New York and in many other states, the decades-long shortage of laboratory staff—especially medical technologists and histotechnologists—has gone from simmer to rolling boil.
Of course, labor shortages are widespread across all industries in the United States. This major trend is known as the “Great Resignation” because so many employees are quitting their current employers. At the same time, employers desperate to fill open positions are finding no takers, despite offering higher wages and increased benefits.
Clinical laboratories and anatomic pathology groups are not exempt from this trend. Lab employees may be quick to resign, with the resulting full-time positions impossible to fill.
Another factor exacerbating staff shortages at labs is the willingness of hospitals and health systems to pay sizeable signing bonuses to medical technologists, clinical laboratory scientists, and other technical lab positions. This encourages lab employees at one hospital to quit and go across town to accept a position at a competing hospital that offers a substantial signing bonus or similar benefit, such as paying down the candidate’s student loans.
Harvest Sown in 1990s
Even as most industries suffer staffing shortages and the Great Resignation grabs news headlines, when it comes to having enough trained and certified lab professionals, the relevant truth is that clinical labs and pathology groups today are reaping the staffing harvest that was first sown during the 1990s.
Throughout that decade, the trend was for hospitals and other lab organizations to shut down training programs for medical technologists (MTs) and other lab scientist training positions. This was done primarily to save money because of the multi-year squeeze on reimbursement from health maintenance organizations (HMOs), Medicare, and state Medicaid programs that marked the 1990s.
Demographics allowed lab organizations to shutter these training programs. After all, there were abundant numbers of baby boomers who, at the start of the 1990s, were entering the most productive years of their careers.
Challenge to Staff at 100%
Thus it was that, in the decade of the 2000s, shortages in the available numbers of MTs, medical laboratory technicians (MLTs), histotechnologists—even phlebotomists—made it challenging for many lab organizations to staff at 100% of authorized FTEs. At this time, it was often pointed out that, by the end of the decade, 60% or more of certified medical technologists would be eligible for retirement within the next five years.
Those demographics were even more critical during the decade of the 2010s. The ongoing retirements of aging baby boomers steadily eroded the staffing numbers. At the same time, the retirement of experienced baby boomer MTs and other types of lab scientists deprived labs of the valuable institutional knowledge these employees had developed during their tenure with lab organizations.
In its coverage of the lab staffing shortage, CAP Today wrote, “In the 1970s there were about 800 accredited medical technology programs in the U.S., compared with [estimates of] fewer than 300 today … But despite the chronic need for trained technologists, programs today typically are filled at a capacity of only 80%. On average only about 250 medical technologists each year graduate from the four-year programs for medical technology in New York State.”
For medical lab directors, this gap means they must not only meet increasing test volume with less workers, but also strive to be more competitive when recruiting and retaining new employees.
Concerns for Lab Directors
Job openings for employers in the lab market is one of the key themes at this year’s 27th Executive War College Conference on Laboratory and Pathology Management. The event is taking place this week in New Orleans.
“In my 30 years covering the clinical laboratory industry, I have never seen such a scramble by labs to hire and retain the needed talent than what is happening today,” noted Robert Michel, Editor-in-Chief of The Dark Report and Founder of the Executive War College.
“Only the leaders of the nation’s largest health system labs and independent lab companies fully recognize the remarkable achievement it was for the clinical laboratory industry to ramp up the huge volumes of COVID-19 testing,” he added. “This feat was accomplished at the same moment in time when lockdowns made it incredibly difficult to hire the phlebotomists, accessioners, and med techs needed to perform this testing.”
It isn’t just med techs and technical staff that are in short supply. The same is true for pathologists. For example, in August 2021, there were 600 pathologist jobs open in the U.S. It may have been the largest number of open positions for that specific position in two decades, a clinical laboratory and pathology practice recruiter noted to The Dark Report at that time. (See TDR, “Record 600 Pathologist Jobs Open Nationwide,” Aug. 16, 2021.)
The Dark Report regularly hears of stories about hospital labs that are operating at anywhere from 65% to 90% of the authorized number of FTEs. To get by, these labs must authorize plenty of overtime hours and bring in temporary MTs. Both are expensive staffing solutions. If there is a positive side to this dilemma, it is that many developers are working to automate manual processes in lab testing. Such solutions cannot come to market soon enough.
Specialization Among Lab Scientists Is One Factor in Ongoing Laboratory Staff Shortage
RECRUITING AND RETAINING ENOUGH CLINICAL LABORATORY SCIENTISTS (CLSs) AND OTHER TECHNICAL POSITIONS to keep labs at 100% of authorized staffing levels has challenged administrators, executives, and pathologists at labs throughout the United States for 10 years or more.
The ongoing shortage of adequate numbers of certified CLSs, medical laboratory technologists (MLTs), microbiologists, histotechnologists, cytotechnologists, and related positions is regularly attributed to the inadequate number of training programs in the United States.
That is certainly a major factor, particularly because the closure of a local lab tech training program is remembered by local lab professionals for years after the event. But another factor contributes to the current shortage of certified medical technologists (MTs) and other lab scientists. That factor is specialization.
Tara Luellen is Vice President of Laboratory Director Services at the consulting and recruiting firm of Lighthouse Lab Services. She works daily with labs that need to hire and retain staff. In a recent interview, she observed that, besides the pandemic and early retirements, there is another contributing factor in the shortage of experienced certified lab scientists. It is the increased specialization with clinical laboratories.
“Today, younger workers who do go into the clinical lab and pathology industry tend to be trained in specialty areas more so now [than] compared to the broader [generalized medical technologist] training programs of the past,” Luellen stated. “Today, clinical laboratories don’t have as many staff members who are more broadly trained [across different disciplines of lab testing].
“Instead, many of this younger generation of laboratory scientists are very specialized,” she added. “So, it takes them years working at labs that do a full range of clinical laboratory testing for these individuals to gain real-life, hands-on experience with those other kinds of testing, compared to the training program that prepared them for a specific specialty in the lab.”
Luellen also identified another factor when recruiting MTs and laboratory scientists. “We see a big shift in what people want in a lab technical position,” she said. “The compensation still must be there, but these people are also seeking a whole community within the lab organization.
“Today’s candidates look for more than just a 9-to-5, punch-the-clock and go-home gig,” she continued. “They want the job to enrich their lives. They want to experience a community at work. It’s a different paradigm in how they look at what work means for them.”