Lab salaries and benefits: dissatisfaction in the ranks; salary freezes and other budget curbs are driving employees to look for new jobs.

Lab salaries and benefits: Dissatisfaction in the ranks

Let's go back to the future. In 1981, when MLO conducted a similar salary survey, many members of laboratory management predicted a talent drain if pay levels didn't start improving significantly during the next few years. Large numbers of laboratorians would quit their jobs and perhaps the profession as well, panelists said.

Salaries did improve, particularly in relation to the cost of living, as Part I of this report pointed out. But were the gains big enough? Laboratory administrators and supervisors generally don't think so.

Speaking about their staffs rather than themselves personally, current MLO panelists report widespread dissatisfaction with salaries. They tell of job hopping and an exodus from the field beyond the departures caused by layoffs. They also see fewer college students opting for medical technology careers.

Turnover would run much higher if DRGs had not limited clinical laboratory job opportunities. As would be expected when employees feel insecure or stuck in positions that do not pay enough, morale is sinking in many laboratories.

Eight-two per cent of the panelists say their laboratories underwent budget reductions or freezes in the last three years. The most widespread restriction, faced by 79 per cent of the affected labs, was a freeze or limitation on filling job vacancies (see Table I).

Other austerity measures include budget cuts, at 59 per cent of the labs; a freeze on capital spending, at 58 per cent; a freeze or limitation on continuing education, at 57 per cent; a freeze or limitation on salary increases, at 47 per cent; and layoffs, at 38 per cent. Sixty-nine per cent of the panelists attributed these restrictions to DRGs, at least to some extent; another 16 per cent said DRGs did not apply to their facilities.

Slightly more than half the laboratories in the Midwest and West had to freeze salaries or restrict increases, versus 37 per cent of the laboratories in the East and 45 per cent in the South. These curbs hit only 39 per cent of the labs in hospitals with 200 to 399 beds, compared with more than 50 per cent of the labs in smaller and larger hospitals.

Budget tightening has affected morale at 86 per cent of the surveyed laboratories, efficiency at 55 per cent, and turnover at 43 per cent (Table II). While morale is down at most laboratories, the effects of reduced lab spending and staff cuts on efficiency are mixed. Several panelists say their labs have actually grown more efficient in adjusting to DRGs.

Here are some comments on these issues:

* "Odd shift patterns, uncertainty about being able to work a full 40-hour week, and a salary freeze have created morale problems."

* "Several older employees have been forced to retire, and other threats of reductions in force have impaired morale. Some employees are looking for other positions as a protective measure. Reductions of FTEs have resulted in reorganization and greater efficiency."

* "The staff does its work at minimal levels. There's little enthusiasm or sense of worth."

* "People are updating their resumes and constantly job hunting. Morale is decreasing, apathy is increasing, so efficiency is less than optimum."

* "After an initial adjustment period, morale has returned to a comfortable level. Our workload has stabilized in some areas and increased in others."

* "Morale is the worst problem. The value and importance of employees go unrecognized, and they feel they have made the wrong career decision. We need to address this problem."

* "We have reduced our staff by 25 per cent in the last two years, and morale has suffered slightly but only temporarily. Our efficiency, by our own and by CAP standards, has improved."

* "Due to good instrumentation, the staff has been able to maintain a high level of efficiency and quality of work."

* "We are down to skeleton crews without time to cope with the workload. It is virtually impossible to provide quality service."

* "Hurrying because of understafing has caused careful technologists to make errors they never made before. I think we are asking the impossible at times."

* "Turnover has slowed. Employees are unable to obtain more suitable jobs elsewhere because other area hospitals are in the same boat or even worse off."

The answer to salary and related problems in the laboratory doesn't appear to be unionization. Otherwise, the labor force would be much more organized today than it was five years ago. Instead, we find union employees in only 18 per cent of the surveyed laboratories, compared with 17 per cent in 1981.

Table III highlights employee attitudes toward current salaries. Ninety per cent of the panelists detect salary dissatisfaction among their co-workers. Twenty-six per cent say co-workers are very dissatisfied; 63 per cent, moderately dissatisfied; and 11 per cent, dissatisfied to a minor extent.

Regionally, the South has the highest proportion of very dissatisfied ratings, 34 per cent, and the Midwest the lowest, 15 per cent. The West stands at 25 per cent; the East, 23 per cent.

All of these percentages are practically identical to those recorded in MLO's 1981 salary survey, which means the situation has not gotten better over the last five years. More lab personnel will leave the profession, and it will be difficult to recruit replacements, the majority of panelists forecast.

Word is getting out into communities about the tougher aspects of a clinical laboratory career. "It is becoming very difficult to recruit for a field that is underpaid and overworked," a group practice laboratorian says.

"Because of layoffs attibutable to DRGs, there are more applicants than job opportunities in our area," a hospital laboratory manager in Texas comments. "We are advising high school students who aspire to become medical technologists to redirect their goals and aim for nursing degrees."

The manager of client services at a Kentucky independent laboratory says lab professionals are held in low esteem, and this factor plus salary limitations are keeping students from entering the field. "Two MT schools in our area cannot recruit individuals into their programs," she notes.

Will salaries improve appreciably in the next five years? Eighty-seven per cent of the laboratorians we surveyed said no (Table IV). That's a big change for the worse from the 64 per cent who were negative about future salary prospects in 1981.

Hospital budgetary problems are the main reason lab salaries won't get a lot better, according to panelists. Other reasons cited are increased automation in labs and a surplus of personnel.

If things are starting to look a little bleak, maybe we can take heart from a hospital lab chief in Kansas City, Mo., who says the field is just in a cycle:

"I think we're experiencing a trend that seems to recur every 25 years. We glut the field, then weed employees out to create a shortage. When I came into the field in 1967, I could have written my own ticket to anywhere. Currently, I wouldn't want to be looking for a job. But I predict that we'll see a shortage again by 1990."