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RESHAPING THE LABORATORY PROFESSION FOR THE FUTURE

By DR. DIANA GARCIA

Keynote Speaker @ the 11th Biennial PAMET-USA, INC Executive Board Meeting.

Philippine Association of Medical Technologists – USA

September 29, 2007

Magandang gabi po sa inyong lahat.

I would like to thank the leadership of PAMET for taking a chance on me and allowing a less than eloquent person, a person of few words such as myself to speak to you tonight. Thank you, Jella, for the glowing introduction that is making me look good up here.

It makes me proud that there are these many Filipino laboratory professionals who have come a long way and chosen to make this country their second home, overcoming a number of obstacles and challenges in the process, and who are now members of this country’s teams of medical professionals. I am sure each one of you has your own migration story to tell and for many of us, it was not so easy. I am very proud of the fact that you have become one cohesive national organization that has been making great strides in promoting the profession and engaging in worthy activities to help the community locally as well as in the Philippines. My congratulations to all of you.

The world of laboratory medicine, like most other fields in medicine, is undergoing quite a transformation. So many exciting things are happening. We now work with much more sophisticated analyzers and equipment that are wonderful when they function well but may be the source of untold grief when they do not! There are so many more tests that are performed, an increase not only in volume but also in the variety of tests. From the time the Human Genome Project was completed in 2003, there has been a rapid development in Biotechnology. The trend is towards molecular testing. We are increasingly faced with “FISH and chips”, and this is expected to continue in the years to come as the ongoing analysis of the results of the Human Genome Project nears completion.

Another change that is starting to impact the laboratory is labor shortage. According to the US Department of Labor’s Bureau of Labor Statistics, job opportunities for medical technologists or clinical laboratory scientists are expected to be excellent. Employment is expected to increase more than 27% through the year 2014. The shortage is due in part to the increase in the volume of tests as a result of: 1) an increase in the population of baby boomers who will require more testing, and 2) an increase in new tests. The other contributing factor to labor shortage is a decrease in laboratory technologists due to 1) a decrease in graduates, and 2) an increase in retirement. According to the American Society for Clinical Pathology, almost half of the current workforce will be ready for retirement by 2010. The Bureau of Labor Statistics estimates that 13,800 job positions will be open each year until 2012! Labor shortage in the laboratory is a reality that I can attest to as my own personal experience in the laboratory I work in.

It is also a fact that medicine has become a business. Just like any other business, the bottom line is often what matters. Cost efficiency, higher productivity, and other economic factors are driving the healthcare industry. In spite of this, as medical professionals we should never lose sight of the real purpose of our work everyday and that is patient care and patient safety. Our primary concerns should be focused on quality, accuracy, and timeliness. Sadly, we all work in the real world where we are constantly challenged with finding means to achieve a balance between these factors. The effect has been increasing consolidation and downsizing. With that, a new trend evolved in the laboratory world beginning in the ‘90s in the form of Automation.

Automation in the laboratory can certainly provide the advantages of higher productivity and cost efficiency. It will help alleviate the labor shortage. It will help with the increased demands of high volume testing. Is it the solution to our current challenges?

Should we allow robots to replace us? Should we lobby against it? Unfortunately, whether we like it or not, technological advances will continue to shape our practice. We cannot stop progress. To prove that point, a large convention called Lab Automation 2008 is taking place in Palm Springs in January 2008 with over 100 podium presentations and over 300 exhibits from at least 215 companies from all over the world, all about new products and latest technology developments.

This brings to mind another burning question: Have we, laboratory professionals, become dispensable? My answer is no. However, we need to work on keeping the answer “no”. We need to make changes in the profession in parallel to the changing technology. The National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) recently produced a paper entitled “The Laboratory Professional of the Future”. In this paper, it is suggested that the technological advances that are forthcoming will make current job descriptions for technologists obsolete. It predicts that educational requirements will change. Personally, I believe that these changes are necessary and inevitable.

With automation, larger amounts of data are produced, hence, the need for laboratory information system specialists. As technology improves, technologists are freed up to perform other tasks, and this may include data management, data integrity, and data evaluation. With additional training in laboratory information systems, you as clinical laboratory scientists would be the better choice to move into these LIS positions as you already have the credibility based on your scientific and technical knowledge as laboratory professionals. You have always been expected to understand the instruments in your laboratory. The changes in the laboratory will require the technologists to expand their knowledge and role. With this added skill, your involvement no longer stops at the instrument.

With automation, technologists are freed up to spend more time on the problem cases that require careful analysis and assessment. We should no longer limit ourselves to running a test and releasing a result. We should be thinking beyond the instrument and understanding the quality, utility and relevance of the test. Otherwise, we will not be doing anything more than what a robotic machine does and that will truly endanger our profession as laboratorians.

We can change the situation and become indispensable. In 2005, a report prepared by the ASCP Task Force on the Future of Pathology and Laboratory Medicine under the leadership of the president Dr. John Brooks, states “transforming the profession will require both a change in the training programs and a change in the activity of the laboratory professional.”

We need not fear technological advances. What we need to do is reshape the profession by reviewing and revising our curriculum with these new trends in mind, and making the new generation of laboratory professionals well-equipped and prepared to face these new set of challenges. Learning a new skill is admittedly a great challenge but those of us who are now just beginning to see these changes are certainly up to that challenge. We cannot just sit back and watch ourselves become collateral damage of the exploding new technology. Even at our age, we can still be all that we can be … and I do not mean to join the Army! We need to take a more central role in patient care by moving away from being just “technologists”, by integrating these new technologies into our daily work, by providing physicians with input concerning test selection and utilization. We should step out of the shadows and assume the role of a scientist and laboratory consultant. We need to be as dynamic as the ever-changing environment that we are in. It will take a lot of imagination, time, and energy but this is our opportunity and responsibility.

On that note, I would like to wish you all continued success in your endeavors and hope that everyone has a lot of fun in our city of Lost Wages.

Maraming Salamat Po.