National salary survey.
The focus on the bottom line is not done through myopic eyes. Though there is (always) room for improvement, the combination of wages and benefits on average is good. Last in a series.
In the August issues, our National Salary Survey revealed the results of our examination of compensation of clinical laboratory employees. We looked at the important issues such as salaries, benefits, and general working conditions. Specifically, Part 1 last month looked at the 1996 and 1995 hourly wages and salaries of the laboratorians who responded to our nationwide survey. Additional income such as raises, bonuses, profit-sharing, and overtime were reviewed, as well.
Further, we attempted to document the level of satisfaction laboratorians are enjoying now compared with the expectations with which they originally entered the laboratory profession. For instance, among the more disillusioned, a medical technologist at a nonprofit hospital in the Midwest had this to say: "Downsizing, rightsizing, whatever you call it, has affected the labs immensely. Our days are a constant battle of survival. The doctors expect their results faster and faster, the government requires more and more paperwork with less and less staff."
Another lab manager/supervisor in an independent lab in the East said, "There are fewer opportunities. I chose this profession due to job stability and because it is something I enjoy. Downsizing has mined any new student's chances to succeed in this field."
Another prognosticator, a lab manager/supervisor in a physician's office laboratory (POL) in the West, said, "I feel that within a 5-10-year time frame, a significant portion of lab testing will be a point-of-care machine, probably noninvasive. There will be very little need for clinical lab scientists except at specialized reference labs. I am making plans now as to what my next career will be."
Perhaps one of the most disenchanted, a blood bank resource tech who works in a 400-bed nonprofit hospital, had this to say: "Your career is a dead-end road if you want to stay in the hospital lab. I have gone from bench tech up through manager. Due to restructuring and consolidation (today's busy words), I am back to where I was 34 years ago. We went from 12 supervisors to no supervisors and one manager."
One assistant medical laboratory technician who works for a POL in the Midwest was only a little less dour. "When I started my first laboratory job in 1967, my wage was high enough to buy a top-of-the-line car, rent a nice apartment, and save money, too. Now, my wage will barely let me drive a 10-year-old car and keep a roof over my head."
Similarly, a non-MD laboratory director in a 216-bed not-for-profit hospital lab in the South had this to say: "The current trend is forcing managers to focus on the bottom line more than patient's outcome. The bureaucracy of whom we can test, where tests can be performed, and billing issues are requiring more time than performing tests. Reference labs are getting the contracts but can't provide the service, putting the hospital in the middle. To take care of the patient, we are often times performing tests we never get paid for."
Even those who indicated they were satisfied with how their expectations measured up with their realities offered a mixed overview of the profession, such as a lab manager/supervisor in a POL in the Midwest who said, "I still find rewards in direct patient contact, direct physician contact, and in being informed of the medical follow-up of a patient's condition. I'm in a POL and we work as a team as much as possible. I am dissatisfied with wages: I drive a 10-year-old car and have not had increases in wages except when I used threats."
Another laboratorian, who works in a 250-bed nonprofit hospital in the East, who registered "satisfied" on this issue, stated succinctly, "I am employed."
A more pragmatic lab director in the microbiology lab of a public health facility on the West Coast said, "I guess my expectations were realistic. When I hit a road block in my career, I found a strategy to work around it: move, change employer, go back to school, etc."
Of those who indicated they were much more satisfied than even their original expectations, one lab manager in a group practice clinic in the West said, "I am not sure I would have been happy doing only testing, but because of my position, I have input into equipment decisions, patient-care issues in our clinic, management experience, and still get to spend a few hours a week doing testing."
It was perhaps most gratifying to hear from a non-MD lab director of a 285-bed not-for-profit county facility who said, "As time goes by, the realization comes that we determine our own level of satisfaction. It's up to us, not someone else. It takes hard work and dedication."
In this, the conclusion of the series, we'll look at the reasons given for the overtime worked in 1996; an analysis of benefits offered versus benefits desired by laboratorians; career advancement and employee turnover; and the impact of downsizing in the lab.
How hard you work, how much you are worth
As stated last month, the mean salary increase of 5.2% in 1996 is a rebound from the 3.9% increase reported two years earlier, and more in keeping with the increases recorded since 1986. When asked to compare the amount of overtime they logged in 1996 versus 1995, about three in 10, or 31.2%, said they worked more overtime hours last year than the year before. Table 1 outlines the reasons given to explain the overtime worked in 1996.
Benefits. While starting salaries and incremental raises are often predetermined, it's often the fringes that help differentiate one job from another. Table 2 shows which benefits are currently offered by the laboratories where the respondents work.
Table 1 Reasons why laboratories worked the overtime they did in 1996 Those who worked less overtime Percent No more OT/financial reasons 26% Less work 23 Additions to staff 21 Overtime discouraged 8 Better technology 8 Unnecessary 4 Technical problems with lab 4 Other 8 Those who worked about the same amount of overtime Percent Same amount of work 75% Administrative work 9 Inadequate staffing 8 More responsibility 6 Overtime discouraged 6 Financial reasons 2 Additions to staff 2 More work 2 Inspection preparation 2 Standard 1 Other 2 Those who worked more overtime Percent Inadequate staffing 36% More responsibility 34 More work 34 Administrative work 14 Financial reasons 6 Technical problems with laboratory 6 Inspection preparation 4 Other 2 Table 2 Benefits and their availability to respondents Currently offer? Benefits YES NO Amount (mean) Dental plan 82% 18% Education reimbursement 1. Tuition reimbursement 70 30 $1,278 per year 2. Continuing ed fees 70 30 $801 per year Life insurance 92 8 Disability 1. Long-term 79 21 2. Short-term 72 28 Maternity leave 86 14 Medical insurance 97 3 Optical plan 52 48 Paid sick days 96 4 11 days per year Paid vacation days 99 1 19 days per year Pension plan 91 9
Of note is that laboratories in the East provide continuing education reimbursement to the greatest percentage of their employees at 80.0%; followed by the Midwest, which provides such reimbursement to 70.7% of its employees; the South, which provides 68.2% of its employees with such reimbursement; and the West, [TABULAR DATA FOR TABLE 3 OMITTED] which reimburses only 57.7% of its employees for continuing education.
By comparison, laboratories in the West provide the greatest percentage of our respondents (65.9%) with an eye care plan, followed by the East (56.9%), South (46.0%), and Midwest (44.8%).
When asked to rank the importance of their benefits, 61.8% said medical insurance was most important, followed by a pension plan (25.0%) and paid vacation days (13.0%). Least important was maternity leave (49.6%), followed by an eye care plan (15.6%), and tuition reimbursement (9.8%).
Broken out further, in terms of the single most important benefit the respondents would like to see added to their benefits package, 19.5% said an optical plan is the most desired, followed by 11.1% interested in a dental plan, 10.9% interested in continuing education reimbursement, 10.3% in a pension plan, 8.8% in disability, 7.5% in tuition reimbursement 4.9% in a family medical plan, 4.3% in profit sharing, another 4.3% in nothing else, 3.0% in paid vacation days, another 3.0% in paid unused sick days, 2.6% in day care, 1.7% in paid time off, 0.9% in overtime compensation, and 0.2% in flex time.
Range of compensation. Not all titles are created equally. Table 3 highlights how some lab professionals are compensated, as well as the average survey respondent's lowest and highest yearly salary in the laboratory for each position.
FTEs in the lab
Examining the average total number of full-time equivalents (FTEs) currently employed in the respondents' labs revealed the following: There were an average number of 26 medical technologists, 10 medical laboratory technicians, 4 medical directors/pathologists, 4 lab managers/supervisors, 3 microbiologists, 2 chief technologists, 1 lab director (non-MD), and 1 clinical chemist, with an average of fewer than 1 bioanalysts, and 17 "other" FTEs currently employed, making for an average total number of 57 FTEs currently employed in respondents' laboratories.
Career advancement and employee turnover
When money and benefits are not the immediate drawing cards to a position, the promise of money and benefits is. Table 4 examines the percentage of laboratorians who typically remain in their positions more than five years, and the percentage promoted within the same lab.
The typical laboratorian who participated in our study has been employed by their current lab for about 15 years. When asked for the primary reasons for employee turnover in their lab, 28.1% cited relocation, 17.2% said because there was a better job elsewhere, 13.3% cited stress, 12.1% said job dissatisfaction, 10.3% said there was little or no turnover, 9.5% said poor salary, 9.1% said retirement, 8.1% said termination, 7.9% said better salary elsewhere, 4.6% cited the need for a career change, 3.2% said lack of advancement opportunities, 2.4% cited parenthood, 1.0% said furthering education, 0.8% said because of poor benefits, 0.4% said because of better benefits elsewhere, and 0.8% cited "other" reasons.
An even 46.0% of respondents said downsizing had occurred in their lab in 1996. Financial/budgeting reasons were the most commonly cited factors for rightsizing of most labs, noted by 38.7% of respondents. These were followed by consolidation (17.4%), an inability to fill vacated positions (15.0%), management decision (11.9%), managed care (9.9%), a lack of work (7.9%), increased efficiency (7.5%), outsourcing of work (2.0%), and other (1.2%).
Breaking this out a little farther, nearly twice the percentage of Midwest and West Coast laboratories (each with 18.8%) cited consolidation as a reason for downsizing the lab as compared with the East (with 10.0%); 17.9% of the South cited this as a reason.
Similarly, 21.9% of both the Midwest and West Coast labs said the inability to fill a position was the cause for downsizing as compared with 11.7% in the East and 16.7% in the South. Lastly, 15.0% of respondents from East Coast laboratories cited managed care as a reason for rightsizing compared with 10.3% of labs in the South and 6.3% of labs each in the Midwest and West.
Commenting on why the lab was downsized in 1996, this chief technologist in the hematology department of a 500-bed nonprofit hospital laboratory said, "Every time a person leaves a position, it is closed to save money. We have shifts without supervisors and will soon have laboratories without managers."
Table 4 Employee turnover and career advancement Percent remaining in Percent same position promoted for more within Title than 5 years same lab Medical dir./pathologist 89% 11% Lab director (non-MD) 81 27 Lab manager/supervisor 88 31 Chief technologist 79 32 Medical technologist 90 16 Medical lab technician 66 14 Microbiologist 86 14 Clinical chemist 82 12
Reflecting on the primary reason for turnover in the laboratory, this chief technologist continued: "Dissatisfaction with the job. There are perceived injustices, such as some employees getting away with doing less work, teaching less, and who are expected to catty less of a work load than others."
This was echoed by a lab manager in the hematology department of a 320-bed not-for-profit, who stated simply: "New management/favoritism."
One medical technologist in a 100-bed nonprofit hospital lab in the Midwest said turnover is the result of the following: "People are getting fed up with the job. Employees work the bench and are expected to take on extra projects. There is little or no respect for laboratorians."
A medical technologist in the chemistry department of a 300-bed proprietary hospital laboratory in the Midwest said, "Our microbiology group leader quit after pay was cut. The general feeling is that nobody ever says 'thank you' for a good job."
While a clinical chemist in a 100-bed nonprofit hospital laboratory told us, "We definitely feel that we are underpaid; we have had a large turnover of phlebotomists due to this problem," an assistant laboratory manager in the chemistry department of a 45-bed nonprofit facility said, "I feel that we are paid very well with excellent benefits." The consensus, as usual, lies somewhere in between.
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|Title Annotation:||clinical laboratory employees; part 2|
|Publication:||Medical Laboratory Observer|
|Date:||Sep 1, 1997|
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