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Who will staff the laboratory of the '90s?

To evaluate the future employment picture for clini- cal laboratories, it is necessary to look at both sides of the workforce equation-supply and demand. Using historical and demographic data, we have forecast the supply for the year 2000, contrasted it to the Bureau of Labor Statistics' demand projections, and found that the equation will be further out of balance than it is today.

In other words, the lab field's staffing shortage will worsen in the decade ahead unless effective countermeasures are taken. Later in this article we will discuss strategies to increase the supply side.

Personnel supply can be projected with this formula: supply in the first year of the projection period plus input of new personnel minus personnel loss through attrition from the field.

For the 1986 base year, the BLS estimated that 239,000 clinical lab technologists and technicians (medical technologists and

medical technicians) were employed. The attrition rate among such personnel is 2 per cent annually, according to the BLS. The remaining variable, input, is the number of persons entering the laboratory workforce. This number is made up of new graduates, individuals from other fields, and ex-laboratorians returning to work.

Major components of supply-the number of new graduates and education programs that produce them-have been significantly reduced in recent years. 1982 was the year prior to implementation of

DRGs and the prospective payment system. This is the point where a dramatic downturn begins to occur.

The latest annual figures, for 1988, show that school closings continue at a fairly significant rate, particularly medical technologist programs. Associate-degree medical laboratory technician programs have not been affected as much as MT programs because they are based in academic in-

stitutions rather than hospitals.

School closings are not the only critical factor. Equally important: Enrollment in existing programs is significantly below capacity. Schools filled only 69 per cent of their available positions for MT students in 1987, and 89 per cent of the MLT student positions. When the MT and MLT student positions are combined, more than 20 per cent of the available student positions went unfilled.

A key reason for the declining enrollment is demography. The number of 18-year-olds is declin-

ing and will continue to decline through the mid- 1990s. Assuming there is a relationship between the birth rate and the number of college graduates in a specified year, it is possible to evaluate this relationship statistically and project the number of graduates for future years.

There is a positive linear relationship between the 1958-66 birth rate and the number of MT graduates 22 years later in the 1980-88 period. Projections for new MT graduates

through the year 2000 uses the regression equation from the 1980-88 data. These projections assume that other social and market factors will remain the same.

Forecasting for MLT graduates is more complicated. An evaluation of the relationship between birth rate and the number of MLT graduates reveals they do not correlate. This was expected given that MLT programs are relatively new in the evolution of clinical laboratory science education and that community colleges pride themselves on reaching non-traditional students. For purposes of the projections, we assumed that MLT programs will continue to be less affected by demographic and institutional factors than MT programs; this led to a constant annual number of 2,300 for projected new MLT graduates.

Some project 239,353 clinical laboratory technologists and technicians by the year 2000, based on the production of new graduates and attrition. That's just 353 more than in 1986. The Bureau of Labor Statistics is the primary source of data on the demand for laboratory personnel. It develops three alternative scenarios taking into account fiscal and monetary policy, population demographics, exchange rates, and unemployment. Low, moderate, and high employment projections are developed from these scenarios. The most recent BLS projections cover the period 1986-2000. The low, moderate, and high projections of clinical laboratory technologist and technician positions are 285,000, 296,000, and 307,000. The moderate level projection

of 296,000 equates to 57,000 ne positions by the year 20 a 24 per cent increase over the number who were employed in 1986. This projection places the clinical laboratory in the top 10 health professions with the most new jobs by the year 2000.

As we have seen, however, there is very little growth between the number of personnel in 1986 and the number projected for the year 2000. If the supply is not increased and no source of supply is available other than new MT and MLT graduates, the result will be a vacancy rate of nearly 20 per cent by the year 2000.

The laboratory community is already experiencing shortages in several personnel categories. Since 1984, the ASCP Board of Registry has surveyed education programs about the employment status of graduates. The employment rates reveal that in most cases the market is absorbing the new graduates as quickly as they are produced.

In addition, a fall 1988 ASCP survey showed that an alarming percentage of positions in the laboratory were vacant.

The survey of 2,000 laboratory managers registered with the ASCP Board of Registry was conducted by Market Opinion Research of Detroit; the response rate was 38 per cent.

Vacancy rates in nine types of positions ranged from 5 per cent for medical technologist supervi- sors and cytotechnologist supervisors to 13.6 per cent for staff cyto- technologists. Other vacancy rates included 8.2 per cent for phlebotomists, 9.3 per cent for staff medical technologists, and

11.7 per cent for histologic technician supervisors.

Many approaches have been recommended to resolve the problem of current and future shortages. The ASCP has identified recruitment, retention, and return (of ex-laboratorians) as the elements that need to be addressed today to insure future survival of the profession.

The society established the Career Recruitment Network last fall as the cornerstone of its recruitment campaign. This network links laboratory professionals, educators, interested students, and high school teachers with one another and serves as a clearing house for information on careers in medical technology.

One phase of developing the network was distribution of a career poster with postage-free reply cards to 20,000 high schools across the country. In the first five months of the project, more than 6,000 high school students and 2,000 science teachers returned a card requesting additional career information.

In addition to the high school students and teachers, other segments of the network now include approximately 1,000 educators and volunteers from the laboratory community. A critical objective is to have at least one resource person available in each local community and laboratory. The volunteer should be committed to meeting with students, answering their questions about career and educational requirements, and arranging laboratory tours.

Early reports from resource volunteers have been enthusiastic and revealing. Talking to pro-

spective students has stimulated practitioners to reaffirm their own commitment to the profession and to carefully examine the value of their work.

Talking to students has also made them feel proud, and they realize that they do want to encourage young people to become part of this important profession. One resource person reports that she has "restyled" her professional image by telling students about her use of new technology at the frontier of medicine and her role in preventive medicine.

Last fall the ASCP published a guide to student recruitment for MT schools and other programs in the laboratory field approved by the Committee on Allied Health Education and Accreditation. There are 12 targets for recruitment efforts. Besides junior high, high school, and junior college students, the targets include "mid-life career changers" and student advisors (for example, guidance counselors and "family influencers").

The guide also provides pointers for building a winning image, in the form of positive messages about the laboratory field. These are useful reminders for student recruitment and may serve to improve the morale of laboratory professionals.

Among the messages: pride in profession, job satisfaction, challenging work, variety of interesting work, team spirit, always new situations, interaction with pathologists and other doctors, opportunities to interact with other hospital/helping professions, recognition as a care giver, recognition for your own contribution to

health, you are needed, you are vital to health and well-being of patients, scientific work, on the cutting edge, new technologies, ready to go to work right out of school, prepared for job unlike B. A. or B. S. students, lots of jobs available.

Retention of existing staff and getting people to return to the workforce are interrelated issues. Many who have left the field had personal and family reasons for doing so. A recent study in Massachusetts found that for female medical technologists there was a significant relationship between marital status and work par- ticipation. The presence of dependents was also a significant factor in the employment status of both technicians and technologists. By providing for the needs of working mothers through flexible scheduling and day-care programs, management will be able to improve retention and increase

the number of returning workers.

Hospital-based education programs also provide recruitment and retention benefits. In a recent article, Hammersberg discusses institutional responsibility and the benefits of providing clinical education for students. Working with students is an effective staff development activity. It can have a positive influence on the professionalism, morale, and enthusiasm of the laboratory staff, and it provides an opportunity to recruit and hire students as they complete their programs.

A number of ideas to bring the supply of laboratory personnel more in balance with demand have been presented. Such other issues as salary, image, opportunities for promotion and advancement, and staff utilization will become front-burner items as we enter the 90s. Improvements in these areas are synergistic and will have a positive effect on recruitment, retention, and return.

The problem should be approached with heightened energies to insure that personnel resources will be sufficient for continued quality in laboratory services to the public.
COPYRIGHT 1989 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
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Article Details
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Title Annotation:medical laboratories
Author:Castleberry, Barbara M.; Kuby, Alma M.
Publication:Medical Laboratory Observer
Date:Jul 1, 1989
Previous Article:Trends in regulation and reimbursement.
Next Article:New lab consolidations: competing on a cost basis.

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