State raises the pay, lowers workload for technicians who evaluate laboratory slides.

State raises the pay, lowers workload for technicians who evaluate laboratory slides

Thousands of aerospace workers may be laid off and many Southland companies may have imposed wage freezes but some health care workers are enjoying salaries that have doubled in the past two years.

Beginning in 1989 the state Senate passed a triplet of health care-related bills. One reduced the workload of specialized laboratory technicians called cytotechnologists, and the second changed the way patients are billed for the work of these technicians. A third bill, passed recently, mandates that laboratories maintain a prescribed level of record-keeping.

The new regulations have had several effects on the health care system but one difference is particularly pronounced - the salary of cytotechnologists has ballooned from $20,000 or $25,000 a year to $50,000 or more.

"The starting salary is sky high," said Stephanie Harner, a cytology supervisor at Tarzana Pathology Services and past president of the California Association of Cytotechnologists.

Starting salaries for cytotechnologists at her laboratory have jumped to $53,000 a year from $25,000 since the legislation was passed, she said.

A cytotechnologist screens and interprets smears of tissue cells that have been attached to slides. They mostly examine Pap smears, which are smears of cells taken from the cervix, but cytotechnologists also look at cells from other parts of the body.

Assembly Bill 32, passed by the state legislature in 1989, requires that cytologists examine no more than 80 slides within a 24-hour period. Previously, some technicians were examining up to 300 slides a day, said Gregory Silvernale, current president of the California Association of Cytotechnologists.

Some technicians were working three or four cytotechnology jobs at the same time; thus their huge number of slides. And some technicians were overlooking some slides or getting burned out, Silvernale said.

When the new regulations kicked in, technicians had to give up other jobs to meet state requirements, Harner said.

Cytotechnology was historically known as a low-paying field but the education needed to be such a technician was almost the equivalent of a Master's Degree. The new law "definitely brought wages up and brought people into the field," said Silvernale, who noted his salary has jumped to $55,000 a year from $20,000.

As a result of the new regulations, though, the quality of Pap smear screening has gone up, industry experts said. "We're pleased to know that the degree of conscientiousness we want to be observed will be observed" said Dr. Malcolm Margolin, a Los Angeles gynecologist.

But now there is a shortage of cytotechnologists in California as well as around the country because more people are needed to screen slides, said Bob Achermann, executive director of the California Society of Pathologists in Sacramento. Pathologists look at the slides the cytotechnologists have deemed to have abnormal cells.

A second law passed by the state, AB 2544, requires that laboratories bill patients directly for the Pap smear tests. Before, doctors often received the bill from the lab and in turn billed the patients.

The passage of AB 2544 in 1990 hiked the cost of Pap smears because laboratories are now forced to take on billing and collection charges for the tests. Patients sometimes have to be billed three times before patients receive a check from their insurance company, Harner said.

When doctors billed patients they simply attached the extra charge to an already existing bill for the patient and laboratories billed doctors only once a month, Harner added.

At Tarzana Pathology Services, a Pap-smear screening used to cost $9 but now costs $25, Harner said. The high prices have resulted from a combination of the changes in billing procedures and cytologists' boosted salaries, she said.

But some industry experts say the new billing method is better. Some gynecologists used to search for the cheapest laboratory around to do Pap-smear screening (often these labs were called Pap mills). The doctors would then add to the Pap smear's cost when they billed their patients, thus making a big profit, Achermann said.

It is much better to bill the patient directly because some doctors formerly used billing for the procedure to make a profit, Harner said.

One gynecologist, however, noted there is another side of the coin - the new billing method has resulted in higher fees to patients because laboratories have to hire billing and collections personnel. Said Dr. Margolin, "The cost to my patients for Pap smears has more than doubled."

A third bill, AB 475, was passed by the legislature in July. The bill mandates that cytology laboratories maintain records of Pap smears, as well as the slides themselves, for 10 years.

"The third law is really nothing new," Harner said, adding that most laboratories have been maintaining records for a long time.

PHOTO : Slides: State limits amount evaluated each day