3 Question with Colonel Gerald Kellar, PhD, MLS(ASCP)SBB, U.S. Army

As a medical platoon leader deployed with an infantry unit to Afghanistan, Gerald Kellar, PhD, MLS(ASCP)SBB, began to appreciate the blood logistics process and what real-time lab results meant to critically injured patients, especially those who were far from fixed facility care. The ability to impact those patients’ outcomes in the future became very important to Dr. Kellar, and he entered the Army’s Clinical Lab Officer’s Course at Walter Reed the year after returning home.  

Later, as the Chief of the Department of Pathology for a military medical center, Dr. Kellar shares what solidified his career in the laboratory, and the legacy he’d like to leave, and more, in this edition of 3 Questions with (and a bonus!).   

Can you share a specific experience or moment that solidified your decision to choose a career in the laboratory?   

We had a pediatric oncology patient experiencing extreme idiopathic thrombocytopenia. For over two weeks, the organization supported this patient’s care, searched far and wide to find available platelets, including a unit I donated. Despite this patient’s dire straits, we were able to support routine patient care and ensure their survival, one of the most noble endeavors possible. 

What do you see as the biggest challenges facing the laboratory in healthcare today? 

The biggest challenge facing healthcare today revolves around available personnel. The clinical laboratory field is an aging profession, with limited means to provide competent replacements for the retiring laboratory professionals, many labs are facing staffing shortfalls, which exacerbates employee burnout, compounding the problem as qualified personnel either enter other fields or take their talents to research-based medicine. These staffing shortfalls informs the second challenge, the financing, operation, and industry acceptance of high throughput testing platforms, with AI capable of interpreting test results in the absence of human interaction. It will take confidence in the system to accept that lack of human touch in the process; however, in the future the handling of the routine specimens will be crucial to ensure the critical values and abnormal results have an experienced tech to make sure the process is properly exercised.      

What do you hope to leave as your legacy in the laboratory? 

I would like to leave a legacy of leadership development. As we lose our retiring leaders, they must obviously be replaced by competent personnel capable of stewarding our labs into the future. We no longer have the luxury of waiting till a laboratory professional has decades of lab experience to find tomorrow’s leaders, senior leaders must begin identifying those with the potential for leadership today, initiate their development process, and make them ready to assume the mantle of responsibility as our senior techs enter their much-deserved retirement.   

If you could help patients understand one thing about the role of pathology or lab medicine in their care, what would it be? 

The operations of laboratory medicine are restricted by the same confines as any other organization, limited by the number of available staff, the resources allocated by hospital administration, and the time in the day to operate. When all hospital beds are full, that facility simply goes on divert. When a doctor’s office has a full appointment slate, they have the luxury of directing patients to a future timeslot. There is no such luxury in the lab; we are required to test the specimens that arrive at our door in the best manner possible, in the timeliest manner possible, with the means available. Further, not all specimens we receive are testable, properly labeled, or in compliance with our accrediting body, a point never made by the submitting providers when we are forced to reject the specimen. The lab is often viewed as gnomes in a cave, specimen goes in, results come out; however, there are a bevy of processes, procedures, quality control, and accrediting bodies between sample submission and results given that are not seen to either the provider or patients.