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Careers in the lab: an open door or a shut case?

CLIMBING THE LADDER of success in the lab is undoubtedly a challenge. What makes the ascent fast and easy for some and slow, arduous, or impossible to others?

Results from MILO's latest national survey on career development indicate laboratorians do not have to bear the brunt of broadening their experience and education alone. The majority of employers (96%) are assisting laboratorians in their professional pursuits by either providing time to attend workshops, paying for seminars, or offering tuition reimbursement, on-thejob training, or some other form of assistance.

Management often encourages laboratorians to build their supervisory skills by having them attend continuing education (CE) programs; oversee the enforcement of FDA, OSHA, or CLIA regulations in their departments; prepare memos and other written documents; introduce change through total quality management TQM) activities; and monitor departmental productivity and cost control.

But many laboratorians (46%) are not taking advantage of such opportunities, and several at the top of the ladder are still middle-aged and male. MLO's survey shows overall 62% of laboratorians are female. For all job titles, except pathologist and lab director, the majority7y of people holding each title are female. Among the 37 pathologists responding to this survey, however, 87% were male, and among the 61 lab directors, 62% were male. For more details on survey participants and procedures, see Survey methodology.'

Advancement barriers

Does a glass ceiling exist? is an underlying bias or prejudice at work in the lab undermining the success of certain employees? Or should we chalk up advancement barriers to the current health care environment?

Education, years in practice, and motivation are just a few of the factors influencing career advancement. Several gender differences, for example, are important to keep in mind when evaluating whether a glass ceiling truly exists for women in the lab. For example, more males than females in our survey hold M.D. (14% vs. 1%, respectively) and Ph.d. 81'/o vs. 3%, respectively) degrees. Further, more men than women (61% vs. 50%, respectively) have done something to broaden their professional perspective. Certain age-related differences should be kept in mind, too. Older people likely have had more years to broaden their professional experience and to take advantage of career advancement opportunities than younger employees. On the flip side, they often must wage an uphill battle against prejudices about being set in their ways and unwilling to change. Bernard E. Statland, M.D., Ph.d., president of Nashville-based National Reference Laboratory, believes advancement usually hinges on whether you view what you do between 8:00 a.m. and 5:00 p.m. as a job or a career." According to Statland, some people put what they do at work very low on their list of priorities and see it simply as a way to make money, while others define themselves almost entirely by what they do for a living. Usually, the latter group advances farther and faster.

Management's role

Eighty-two percent of laboratorians who responded to our survey believe upper-level hospital management should assume some responsibility for employees' career development. Slightly more males than females believe this (87% vs. 80%, respectively).

Apparently management is responding to this opinion; virtually all laboratorians (96%) are aware of at least one thing their employer does to aid employees' professional development. For example, more than eight out of 10 of respondents (82%) report their employers provide time for them to attend workshops or training sessions, more than three-quarters (76%) say their employers pay for seminars or workshop expenses, and almost two out of three (64%) report employers reimburse tuition for college or university courses. Figure I lists more ways employers are helping laboratorians develop their careers.

Despite the opportunities provided by employers, almost half of laboratorians (46%) have done nothing up to this point in their careers to broaden their professional experience. A mere 14% have volunteered to work in a different lab setting and 9% have participated in international work/study programs. Only about one-third of respondents (35%) claim to have participated in some other activity.

C. Anne Pontius, MT(ASCP), CLS(NCA), president of Raleigh, N.C.-based Laboratory Compliance Consultants, notes, "The term `job stability' is no longer relevant; on the other hand, the term 'career stability' is. do thin to further our careers so we can go from place to place if necessary and be employable."

She believes, as our survey illustrates, management is providing opportunities, and, in many cases of reengineering, is retraining and cross-training employees who would otherwise be unemployed. "Perhaps the people who haven't done anything don't want to change, but the health care environment is constantly changing. If laboratorians don't change with it, they'll surely be left behind," Pontius adds.

Lucia M. Berte, M.A., MT(ASCP)SBB, DLM, a consultant based in Elmhurst, Ill., says, "Career development is at minimum a 50/50 responsibility between employee and employer. Employers need to offer opportunities, and employees need to take initiative. Managers are more likely to nurture those who show interest and more likely to ignore those who don't.'

Pathologists were least likely of all lab professionals to receive time off to attend workshops, tuition reimbursement for college, or on-the-job training, yet these professionals were the most likely to have volunteered to work in a different lab setting, participate in international work/study programs, or join the military reserves. More laboratorians under age 40 have not yet done anything to broaden their professional experience than those age 50 and older (57% vs. 36%, respectively). And laboratorians from large hospitals were more likely to take action to broaden their experience than those from small or midsize hospitals (63% vs. 53% or 50%, respectively).

Berte feels the reason for this is, "Larger institutions -- particularly those that offer intern and residency programs -- offer a lot more in-house CE opportunities (grand rounds, lectures, conferences) in which everyone can participate." (For a definition of the hospital sizes used in this article, see Hospital size.")

Career advancement

Despite that almost half of all laboratorians surveyed have done nothing to broaden their professional experience, nearly nine out of 10 (89%) feel career advancement is extremely or somewhat important. Ten percent claim it is not very important, and 2% say it's not important at all. Pathologists and lab directors/managers/ supervisors/administrative directors are more likely to place extreme importance on career development than other lab professionals surveyed (43% and 40% vs. 30%, respectively).

Slightly more males than females believe career advancement is extremely important (40% vs. 35%). And yet when you combine those who feel it is "extremely" important with those who feel it is "somewhat" important, males and females have almost identical views. Finally, survey respondents working in large hospitals seem to place greater importance on career advancement than their colleagues employed in small or midsize facilities (41 % vs. 32% or 36%, respectively).

Most laboratorians claim their primary motivation for career advancement is personal satisfaction (39%), followed by survival in a changing environment (23%), improved management opportunities (11%), money 9%), professional recognition/prestige (7%), expanded technical capabilities (4%), and loyalty to organization (2%). Four percent have no interest in advancing their careers at this time.

To improve their chances for advancement in the past two years, laboratorians most often have maintained professional certification, participated regularly in CE activities, and networked with peers at meetings/ conferences/workshops (84%, 76%, and 68%, respectively). One out of two laboratorians also have identified a specific problem in the lab and/or developed a solution or presented in-service sessions (57% and 52%, respectively).

More females than males have volunteered to train new employees or to work with students (50% vs. 35%, respectively). Otherwise, men and women have taken similar actions to improve their chances for advancement. Fewer laboratorians under age 40 have participated regularly in CE activities than those age 40 and over (67% vs. 78%, respectively). Nine out of 10 pathologists (920/o) regularly participate in CE activities, more than any other lab personnel.

While many sources of CE are available to laboratorians, local, state, or national professional meetings are used most often (by 57% of survey participants), followed by vendor-provided technical education/training (36%). One out of four laboratorians use hospital-based activities 28%), and 23% depend on journal articles. See Figure 2, p. 37, for a complete list of continuing education strategies.

It seems management also encourages the building of employees' supervisory skills as another means for advancing their careers. For instance, 74% of employers encourage employees to attend CE programs; 67% delegate employees to oversee the enforcement of FDA, OSHA, and/or CLIA regulations; and 62% advocate employees preparing memos and other written documents. While such skills would seem to be important for all employees, more lab directors/managers/ supervisors/administrative directors are encouraged to build supervisory skills than other laboratory personnel. See Figure 3 for a complete breakdown on what laboratory management does to encourage staff members to build supervisory skills and for a comparison between titles.

Not everyone can, or desires to, advance their career in the direction of a manager. Nevertheless, a third of respondents (32%) were unaware of any nonmanagement career path in their organization. Those who knew of a nonmanagement career path cited the positions of safety officer, LIS specialist, compliance (QA) coordinator, and infection control officer (mentioned by 44%, 40%, 37%, and 33%, respectively) most often. Other positions mentioned were ancillary testing coordinator 25%), continuing education coordinator 22%), and education coordinator for lab tech program/school (22%). As institution size increases, so does the availability of a nonmanagement career path (see Figure 4).

Despite all the emphasis on career advancement, laboratorians are clearly divided when it comes to defining it. Thirty-eight percent define the term as "being given increased responsibility in a current position"; for 35%, it means "being promoted to a supervisory position"; 15% define it as "taking on specialized responsibilities" (e.g., becoming a safety officer); and 4% equate career development with becoming involved in some type of outreach activities (e.g., ancillary testing).

Prejudice: A predator in the lab?

Overall, 73% of clinical laboratorians feel there is no bias or prejudice at work in the laboratory preventing certain employees from advancing their careers; 17% disagree, and 10% are unsure. Perhaps not surprisingly, almost twice as many women as men feel bias or prejudice exists (20% vs. 12%, respectively). Proportionally, more lower-level professionals report bias/prejudice than pathologists and laboratory directors/managers/ supervisors/administrative directors. Furthermore, slightly fewer laboratorians from small hospitals feel there is bias/prejudice hindering their careers than laboratorians from midsize or large hospitals (15% vs. 20% or 21 %, respectively).

The less satisfied laboratorians are in their current position, the more likely they are to feel bias or prejudice exists. Berte says this is partly a result of it being easier to blame external forces than to put forth personal initiative to change a situation."

Statland believes there are more opportunities for women to advance in the lab than in many other professions, simply by virtue of the fact most of the people who work in the lab are women.

Among laboratorians who feel bias and prejudice is alive and well in the laboratory, 72% report having experienced it themselves; 46% report knowing someone else who has fallen victim to such a situation. While close to one-half the laboratorians (47%) mentioned sex-based discrimination, 30% reported age-related prejudice as occurring most frequently. Not surprisingly, substantially more females than males mentioned sexual bias (53% vs. 33%, respectively), and more than half (55%) of those mentioning age-related bias were age 50 or older.

Pontius, who manages a national database of consultants, is not at all surprised by the age-related prejudice noted in the survey. "I see resumes of individuals 50 years and older who are extremely qualified for management positions but who are having great difficulty finding employment," she notes. "I also see more and more people in their fifties and sixties being asked to take early retirement."

Another obstacle: The state of health care

Aside from bias and prejudice, nearly three out of four (73%) laboratorians feel the current health care environment is preventing lab workers from advancing their careers. Slightly more females believe this than males (75% vs. 69%, respectively). Eighty-six percent of the laboratorians who feel there is bias/prejudice impeding advancement also believe the current health care environment is to blame. Feelings toward the current health care environment's effect on career advancement seem to go hand in hand with job satisfaction. In other words, those who are more dissatisfied with their current position are more likely to feel the current health care environment is preventing them from advancing.

Among those who blame the current state of health care, downsizing is viewed as the major factor by 63%, followed by managed care (27%) and automation 3%). Fewer younger laboratorians mentioned (downsizing) than those age 40 and over (57% vs. 65%, respectively). And fewer laboratorians in small hospitals cited downsizing as a hindrance than those in midsize or large hospitals (59% vs. 77% or 70%, respectively).

For 21 % of laboratorians, reengineering (or downsizing) has had a positive impact on advancement. But for most 43%), it has had minor/major negative effects. Perhaps most surprising, 36% report having been completely unaffected by reengineering, a number fairly consistent across geographic regions and job titles. Still, more people in small facilities reported being unaffected (42%) than people in midsize and large facilities (32% and 24%, respectively).

Linda Blacklidge, M.M., MT(ASCP), director of laboratory administration for Evanston Hospital in Evanston, Ill., theorizes the fact that more than one-third of those surveyed report being completely unaffected by reengineering may reflect the way in which their institutions chose to restructure. She explains, "At our institution, for example, we downsized by 20%, but we did it through attrition, not by laying people off. So if you asked staff members at our facility if they've been affected by downsizing, most would probably say no."

Survey methodology

On December 4, 1995, MLO mailed an eight-page questionnaire with postpaid return envelope to MLO's 1,657-member Professional Advisory Panel, consisting of MLO readers who have agreed to participate in our national surveys. The survey was prepared by MLO editors in collaboration with the Medical Economics research department.

By the cutoff date (approximately six weeks later) respondents returned 865 usable questionnaires, yielding 52% response rate. Two notes: Because the sample represents selected panel of laboratories, results may not necessarily represent the views and experiences of all laboratories. In addition, totals that don't equal 100% are due to rounding or the acceptable of multiple responses.

Of those returning usable questionnaires, 27% listed their title as laboratory manager, 18% as lab section supervisor, 9% as administrative director, and 9% as MT or MLT. Of the remainder, 7% are lab directors; another 7%, section heads; 5%, chief technologists; 4%, pathologists; 2%, assistant chief technologists; and another 2%, education coordinators. The average respondent has been practicing lab medicine for 23 years.

Fifty-two percent of respondent are employed by nonprofit hospitals, 7% by Government or Armed Forces hospitals, 6% by proprietary hospitals, and 34% by other labs.

In terms of setting, 45% are employed in urban labs, 28% work in the suburbs, and 26% are employed in rural areas. Respondents are from all regions of the country: the Midwest (30%), South (30%), East (23%), and West (17%).

Seven out of 10 laboratories hold B.S./B.A. degrees; 21% also hold an M.S. or M.A.

The majority of laboratories (63%0 are between the ages of 40 and 54, but the majority of pathologists (71%) are age 50 or older.
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Title Annotation:survey of medical technologists; includes related article on survey methodology
Author:Maher, Lisa
Publication:Medical Laboratory Observer
Date:Apr 1, 1996
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