Acute Histotech Shortage Grows Across the USA

Trends in histology point to a widening gap between supply of labor and demand by labs

CEO SUMMARY: Pathology laboratories are enjoying steady increases in specimen volume and revenue as new molecular assays gain acceptance by clinicians. However, the supply of histotechnologists is failing to keep pace with growth in the volume of tissue-based testing. One executive who places histotechs into laboratories predicts that competition among labs for skilled histotechs will intensify.

IT’S A GOOD NEWS/BAD NEWS STORY in anatomic pathology. Clinical demand for tissue-based diagnostics is exploding as new technologies make it possible to diagnose cancer and other diseases with more accuracy and sensitivity.

However, most laboratories are unable to hire enough histotechs to process the current volume of specimens. The national and regional shortage of histotechs is fast-becoming a universal problem. Some regions have even seen laboratories engaged in bidding wars for skilled histotechs.

“There are two main reasons for the shortage of skilled technicians in pathology: low pay and high stress ahead,” explained Anthony Williams, founder and CEO of the Histotech Exchange, LLC, in Lexington, Virginia (

“While the rate of pay for technicians has risen slowly in recent years, the increase has not been sufficient to attract and keep skilled technicians in most positions,” he said. “Seeing pay rates that can be 25% higher in other positions, many techs shun low-paying work and seek better-paying jobs.”

The shortage of technicians in anatomic and clinical pathology labs is well documented. The American Society for Clinical Pathology (ASCP) reported in August that some 44% of hospital, reference, and physician office laboratories were experiencing difficulties recruiting or hiring medical laboratory personnel. The ASCP findings came from a report based on 2005 data.

Histology Wage Gap

“This shortage has been with us for some time, and part of the reason is that the average annual wage for a histotech has been stuck at about $30,000 in recent years,” Williams observed. “Other technical staff working in laboratories often earn about $40,000.

“For many histotechs, it’s easy math to figure that they are making less money than those in other technical positions. They ask, ‘what’s the point of going into histology?’ They might as well go into clinical chemistry, hematology, or other areas because that extra 25% makes a big difference.

“Further, not only is the pay low relative to other positions in the lab, but there is a high stress level,” commented Williams. “When you do a repetitive job, it’s extremely easy to make mistakes. It’s easy to transpose a number. Now you have an error and who knows what will result from that error? It could be something minor or it could end up harming a patient.

Burnout And Retirement

“Along with high stress comes burnout,” Williams added. “Relatively low pay for histotechs and the shortage of staff means many laboratories over- work their staff to the point of burnout. Add to that impending retirementsome statistics indicate that between 50% and 70% of histotechs are planning to retire in the next 10 years. That will only exacerbate the shortages we see now.

“In addition, labs try to do more today than they have done in the past,” he said. “That requires all technical positions to work at very high levels of productivity, also increasing stress. Pathologists know the work they do is stressful. But they often fail to recognize that the histotechnologist also has a stressful job.

“A histotech might cut 350 to 500 blocks a day,” Williams said. “Or, the histotech might imbed a large batch of blocks, or similarly handle many specimens in grossing. At each of these stages, there is opportunity for error. Furthermore, ongoing increases in the volume of specimens to be processed during each shift also contribute to increasing the level of stress in the lab.

“Keep in mind that the work done by histotechs is much less automated than most other disciplines in the laboratory,” noted Williams. “Histology today is organized around mostly manual work processes. In every lab, you can see the handprints of the histologist on the final product.

“People who care about histology recognize that the situation is like a perfect storm,” Williams added. “When the numbers of samples to process go up, the stress level goes up, and the more stress you have, the more burnout you get on the job.

“There’s another squeeze on laboratories. Because the workload is already high, they need new histotechs on the job now,” said Williams. “But, because the workload is so high, there’s no time to train anyone. To solve this problem will take time.

“Laboratories will have to pay more,” he predicted. “In Connecticut, a colleague of mine was given two pay upgrades in two years because labs in that state are trying to retain their histologists. Proactive pay increases to keep histologists from jumping to other jobs indicate that there is a bidding war. That’s good news for histotechnologists.

“The shortage is also good news for those of us who are trying to fill these positions,” added Williams. “Help wanted ads make it easy to see that employment agencies are robbing Peter to pay Paul. They take techs away from some jobs and put them back into other jobs for more money. Most agencies charge anywhere from $60 to $110 an hour for technicians. So there is a big spread.”

Shortage Will Increase

THE DARK REPORT was first, several years ago, to note that the shortage of histotechnologists was actually more acute in most regions than the shortage of medical technologists. As indicated in this briefing, demand for histotechs will outstrip the supply for many years into the future.

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