News

The U.S. Department of Labor Bureau of Labor Statistics (BLS) reported that the job outlook for medical and clinical laboratory technologists and technicians between 2020 to 2030 is expected to grow 11%—faster than the average rate for all occupations.¹ While the job outlook appears promising, a recent report on the workforce published by ASCP and the University of Washington Center for Health Workforce Studies (UWCHWS) stated, “there is evidence that laboratory workforce shortages will likely increase in the near future due to increased demand for laboratory services, diminished education and training opportunities, and barriers to recruiting and retaining clinical laboratory workers.”²

Further, the U.S. Labor Department data published January 12, 2023, reported that the annual inflation rate for the United States was 6.5% for the 12 months that ended December 2022 after rising 7.1% previously.³ While the current inflation rates are lower compared to last year’s report, it is still three times higher since 2012.3 Results from the recently published ASCP Wage Survey show that by occupational level, salaries are up only for staff-level CTs and MTs/MLSs/CLSs, after adjusting for inflation⁴ (Table 1). Most staff-level occupations show a decrease in hourly wages ranging between -0.53% up to -5.48% (Table 1). The hourly wage for leads is also up in 2021 for all the occupations surveyed except MTs/ MLSs/CLSs, PAs, HTs and CGs (Table 2). Supervisors’ hourly wages are up compared to 2019 except for MTs/ MLSs/CLSs (Table 3). Most occupational titles reported at the lead and supervisor-level experienced wage rate increases in 2021 (Tables 2 and 3).

The wage survey also examined the differences in salaries by geographical region, years of experience in the field, and gender. Lastly, respondents were asked to provide comments after completing the survey. A total of 2,801 comments were received and showed that 50.1% addressed being underpaid. Respondents stated that their wages continue to remain low with respect to their occupational role, title, education, and years in the field. Full-time staff also commented that they received lower salaries compared to those who are traveling laboratory professionals. In addition, respondents reported lack of appreciation and recognition from hospital management and other providers, and lack of visibility of the profession among the public, 14.0%. Hiring, retention, and staffing challenges were among the top topics that resulted from the qualitative analysis, with 12.3% (compared to 4.93% in 2019) of respondents indicating that there are currently low retention rates and employers continue to experience difficulties finding applicants.

New to the wage survey report are comments on the impact of the pandemic on laboratories. This includes staffing changes, effect on test volumes, supply shortages, impact on salaries, etc., 12.1%. Participants also asked for greater representation through advocacy, 10.8%; expressed having burnout from stress and workload and lack of work-life balance exacerbated during the pandemic, 3.9%; and increased workload during the pandemic worsened by the staffing shortage, 3.6%.⁵

Impact of COVID-19 on salary and staffing

The COVID-19 pandemic forced many in the clinical laboratory workforce into the spotlight² and significantly affected many laboratory professionals’ staffing, workload, and work-life balance. To provide a view of how laboratories throughout the country are affected by the pandemic, ASCP collected laboratory workforce data on the impact of COVID-19 on wages, burnout, laboratory testing, and staffing. ASCP administered a similar survey in 2020 that asked individuals with management-level positions or human resources (HR) positions to answer questions on whether there have been changes in testing, staffing, and retention of laboratory professionals during the COVID-19 pandemic.⁵

When asked how the COVID-19 pandemic altered the participant’s salary, 84.0% indicated that there had not been a change in their salary at this time.⁵ Those whose salaries decreased reported that the decrease was only temporary, 80.8%; 19.2% reported that it was permanent. 5 In addition, pre-COVID-19 data indicate that laboratory professionals already experience burnout due to the quantity of workload and understaffing.⁶ During the COVID-19 pandemic and when this survey was administered, more than half of the participants reported “presently experiencing burnout,” 52.5% (35.8%, no and 11.7%, not sure/don’t know). As a result of feeling burned out, 37.1% of respondents are considering a similar position in a different clinical laboratory, and 30.5% are considering changing careers completely.⁵

Laboratory professionals have played a key role in the fight against the pandemic through timely and accurate reporting of test results. However, many reported lack of appreciation and recognition from the hospital administration, contributing to burnout and causing them to leave the field. This underscores a need to recognize the essential contributions that laboratory professionals make to patient care and support their efforts.² These supports include financial incentives, continuing education, flexible work scheduling, recognition of value to healthcare teams, and opportunities for professional development and career advancement.²

The COVID-19 pandemic has also increased the urgency to ensure a steady supply of incoming laboratory professionals. Examples of solutions include developing clearly defined pathways for individuals who may be interested in entering the laboratory workforce, addressing retention challenges (salaries, burnout, providing opportunities for career progression), advocating for higher wages, and identifying structural barriers and solutions that may affect equitable access to employment in the laboratory professions or entering the field.²

 

A call to action

Even with the salary increases reported from the results of this survey, it is evident that the increases have not kept up with the current inflation and understaffing persists.

As a response to these urgent challenges, ASCP’s Laboratory Workforce Steering Committee, formed in May 2022, began developing projects to address visibility of medical laboratory occupations, recruitment and retention strategies to strengthen the pathways into laboratory careers, and increase focus on diversity and inclusion in the laboratory.² These projects will not only build on the resources and toolkits currently offered by ASCP but will also identify innovative ways to meet the goals. Further, the committee is currently identifying and engaging with key partners in all projects to make the efforts far-reaching and sustainable.

Recently, ASCP was also awarded a three-year cooperative agreement through the Centers for Disease Control and Prevention’s (CDC) Division of Laboratory Systems to support the OneLab Initiative, aimed at creating a sustainable community of practice among domestic clinical and public health laboratory professionals and educators. Through this effort ASCP, CDC, and three other award recipients will work together to engage members in the OneLab Network and support awareness of and access to CDC’s new learning management system, OneLab REACH, to strengthen the collective laboratory community and its preparedness for potential public health emergencies. Since its kick-off in September 2022, this grant has engaged ASCP’s Commission on Science, Technology, and Public Policy, Laboratory Workforce Steering Committee, Council of Laboratory Professionals, and Effective Test Utilization Committee for support.

Laboratory workforce research continues to be a main focus for ASCP, with studies on the impact of the pandemic on staffing in the laboratory and well-being research underway. We also encourage the community to review the Blueprint for Action, which summarizes the needs identified from the Garcia et al report and recommended actions to address challenges and barriers supported by the report findings.^2,7 Each aim presents recommendations with action items aligned with the three focus areas and includes key actors, target audiences and suggested tasks.⁷ The ASCP Wage Survey will be launching in April 2023.

Lastly, the ASCP has launched its Laboratory Workforce and Career Advancement Resources Program to offer workforce planning services and practical advice for pathologists and laboratory professionals who are recruiting new employees, looking to expand their organizational development, culture, and retention efforts, and resources to those who are seeking employment.

References

1. Occupational Outlook Handbook. Bureau of Labor Statistics Website. https://www.bls.gov/ooh/healthcare/clinical-laboratory-technologists-and-technicians.htm Accessed February 3, 2023.
2. Garcia E, Kundu I, Kelly M, Guenther G, Skillman SM, Frogner B. The Clinical Laboratory Workforce: Understanding the Challenges to Meeting Current and Future Needs. American Society for Clinical Pathology (Washington, DC) and Center for Health Workforce Studies, University of Washington (Seattle, WA), April 2021. https://ascpcdn.s3.amazonaws.com/static/ISTP/ASCP_UW_Clinical+Laboratory+Workforce_Report_2021.pdf
3. Current US Inflation Rates: 2000-2022 | US Inflation Calculator. US Inflation Calculator |. https://www.usinflationcalculator.com/inflation/current-inflation-rates/. Published 2022. Accessed February 3, 2023.
4. CPI Inflation Calculator. https://www.bls.gov/data/inflation_calculator.htm Accessed February 3, 2023.
5. Garcia E, Kundu I, Fong K. The American Society for Clinical Pathology’s 2021 Wage Survey of Medical Laboratories in the United States, Am J Clin Pathol. 2022;158(6):702-722. https://doi.org/10.1093/ajcp/aqac116
6. Garcia E, Kundu I, Fong K. The American Society for Clinical Pathology’s 2021 Wage Survey of Medical Laboratories in the United States, Am J Clin Pathol. 2022;158(6):702-722. https://doi.org/10.1093/ajcp/aqac116
7. C. Garcia E, Kundu I, A. Kelly M. Blueprint for Action. ascpcdn.s3.amazonaws.com. https://ascpcdn.s3.amazonaws.com/static/ISTP/Siemens_Clinical+Laboratory+Workforce_Blueprint.pdf Published 2022. Accessed June 30, 2022.