Borrowing MLB’s general approach to talent development could unlock a path forward.
Based on an article by Jim Payne from the AMT Pulse, Summer 2023.
Laboratory medicine, as an industry, is in an extreme employment crisis that has the potential to collapse our laboratory testing capacity. Medical laboratory scientists (MLS) perform an estimated 14 billion tests annually in the United States.1 As the number of tests continues to grow, there is an increasing need for new medical laboratory employees. For example, the U.S. Department of Health and Human Services has reported that MLS and MLT careers will each grow 19% through at least 2030.2 To put this in terms of actual openings, we need almost 26,000 employees each year through at least 2030; as of now, our colleges and universities only produce 5,000 graduates per year.
Burnout, a common problem, is dramatically hurting our ability to keep lab employees. According to Garcia et al, 52.5% of respondents were burnt out, with 37.1% of those considering staying in their current role but in a new laboratory while 30.5% planned to leave the field completely.4 The gap created by the lack of effective recruitment and significant burnout means that if we do not change what we are doing, it is unlikely that we will fix the problem in time.
High School Medical Laboratory Programs
Before I discuss one solution to the employment crisis, let me describe my high school medical laboratory assisting and phlebotomy program. My students learn over 60 laboratory and phlebotomy skills while they are juniors and seniors in high school. They get the opportunity to participate in a total of 120 hours of co-ops with local medical laboratories. My juniors participate in a co-op in phlebotomy, drawing blood on real patients for real samples with a laboratory trainer for one week (five, eight-hour shifts). In their senior year, they go to a local blood bank to shadow and assist for 40 hours. They learn about the entire process from collection to specimen processing to the quality control of the blood products. Also in their senior year, they spend another 40 hours training on all aspects of being a medical laboratory assistant, including accessioning, aliquoting, troubleshooting and customer service.
My students are well-prepared after they graduate to work in labs or join college medical laboratory programs. This is why we have articulation agreements with nearly every medical laboratory-related college program in New York. These agreements help my students enter programs more easily. The reason colleges are willing to help my students enter their programs is they are confident that my students come highly qualified and are more motivated to succeed because they have already worked in laboratory medicine as part of their co-ops.
Transforming Our Mindset
The current predominant mindset separates entry-level staff, such as phlebotomists and MLAs, from the college requiring roles in the laboratory such as MLT and MLS. This separation supposes that the entry-level staff have an important role but are not going to be college-requiring laboratory medicine employees. We all need to realize that entry-level laboratory employees are vital to ensure that college-requiring laboratorians can work as effectively as possible, but entry-level staff could also be a large pool of potential future college-requiring employees. This transformation should be industry-wide and will require laboratory organizations, laboratory training programs, laboratory administration and even individual laboratory employees to get on board with this mindset.
The Minor Leagues
I like to use an analogy of professional baseball, which has minor leagues and the major league. The minor leagues develop and provide talent to their parent team. For Major League Baseball to have enough talented players, it must have a robust minor league system that allows minor league players to move up. But not every player will do so; some players spend their entire career, even decades, in the minor leagues but still contribute significantly to the broader organization’s success (and love what they do).
The way laboratory medicine is currently set up, we already have our own minor and major league teams. The minor league is the entry-level workforce, such as the phlebotomists and MLAs, and the major league includes the positions that require a college degree. When we look at it this way, we see our minor league staff as not just doing entry-level work for their career but that some or even many of them could move up to the majors by going to college for a medical laboratory program. To ensure this works, just like minor league baseball, we need to invest in our “players” by improving their knowledge and skills so that they are ready to enter one of the “major league” college programs. Programs like mine certainly make it easier because my students are more knowledgeable and skilled in college-level content than typical minor league staff. That does not mean that we couldn’t also help current minor league staff catch up through enhanced in-house training classes.
Transforming our mindset will take time. I hope that this article will inspire AMT’s thousands of members and its 121 training program directors to help me in actively reaching out to other national laboratory organizations, non-AMT training programs, their own laboratory administration and other laboratory employees to explain how we need to start thinking of our minor league staff as future major leaguers. This isn’t the complete solution, but it could make a big dent in the major employment crisis and ease staff burnout. Let’s help our minor leaguers join the majors!
- Centers for Disease Control and Prevention. “Strengthening Clinical Laboratories.” 2018. Retrieved from: cdc.gov/csels/dls/strengthening-clinical-labs.html
- Halstead, D. C., and Sautter, R. L. “A Literature Review on How We Can Address Medical Laboratory Scientist Staffing Shortages.” 2023. Laboratory Medicine. 54(1), e31–e36. Retrieved from: doi.org/10.1093/labmed/lmac090
- 3. Scott, K. “New Grassroots Organization Aims to Advocate on Behalf of Clinical Lab Professionals.” Clinical Lab Manager. 2022. Retrieved from: clinicallabmanager.com/insight/new-grassroots-organization-aims-to-advocate-on-behalf-of-clinical-lab-professionals-26188
- Garcia, E.; Kundu, I.; Fong, K. “The American Society for Clinical Pathology’s 2021 Wage Survey of Medical Laboratories in the United States.” American Journal of Clinical Pathology. 2022. Retrieved from: doi.org/10.1093/ajcp/aqac116