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Lab Tech Shortage Causes ED Bottlenecks

Cheryl Clark, for HealthLeaders Media, May 14, 2009

It's the fear of any hospital administrator. The emergency room is backed up again because blood tests aren't being run quickly in the lab, creating a bottleneck throughout the system. Or, patients can't be diagnosed also because there's no radiology tech to operate the CT.

That's a realistic future scenario in California and many other states now realizing that their so-called "invisible workforce" of allied health professionals, such as nurses, clinical lab scientists, respiratory therapists, and pharmacists, are closing in on retirement. And there are far fewer younger workers on their way in to replace them.

"The age of our allied health professionals is higher, but we're not educating enough people to take their place when they move on," says George Proctos, vice president of human resources for Healdsburg District Hospital, a 43-bed critical access facility north of Santa Rosa.

Add to the problem the increasing demand for such skills from biotech and academic settings, especially as the patient population ages and demand for personalized medicine increases.

"Allied health" is a broad category of health worker, but most dire shortages are seen for nurses, clinical lab scientists, medical lab technicians, imaging technologists for MRI, mammography, ultrasound and nuclear medicine, respiratory and physical therapist, pharmacists, and pharm techs, says Cathy Martin, director of the California Hospital Association's workforce project.

That's why the CHA held a day-long workshop this week for colleges looking for solutions. They want to increase their medically-trained students as well as more faculty to keep the pipeline open. And one way to do that is to encourage hospitals, labs, workforce training programs, and labor unions to work together to get more young and diverse students into these fields, Martin says.

Arrangements may be worked out to allow more students on-site, hands-on training in clinical settings, or find ways to allow some workers with a few required skills to take additional courses and be recertified without starting the educational process anew.

Pay scales are also an issue, with some required workers starting at just slightly above the minimum wage in rural communities as opposed to much higher salaries in urban areas.

The U.S. Bureau of Labor Statistics reports 69,000 more clinical lab scientist and 68,000 more medical lab technicians will be needed by 2012. But education programs currently in existence produce only 4,500 graduates annually, resulting in a 9,200 annual shortfall nationally.

According to one study by the Heath Workforce Solutions project, 60% of the health occupations in California are in allied health and are experiencing shortages now. In just five years, another 206,000 additional health professionals will be needed throughout the state.

Even now, those signs of shortage are starting to appear, says John Bibby, human resources official for two Catholic Healthcare West Hospitals in Ventura County, who now relies on sharing some technicians with other hospitals, or using registries to fill some nursing and other allied professional positions, which is more expensive.

He'd much rather hire his own to ensure security and dependability for St. John's Regional Medical Center and St. John's Pleasant Valley Hospital.

"A few years from now, our clinical lab scientists will be moving on, and we'll have a gap unless we resolve this problem," he says. "If we don't have the proper people to run these patients through our emergency departments, it will mean more delays in patient care."

Bibby says it hasn't gotten to the point where he's desperate. But a few years ago, he wouldn't look at a professional without some experience. "Today, we'd hire a student coming out of college with a certificate or degree where that wouldn't be my first choice before."

Martin says that regional solutions are the key. One good thing is that funds from the American Recovery and Investment Act allows Workforce Investment Boards (regional agencies that give federal, state, and local funding) to allocate money to community college districts needing to increase their reach, where they couldn't before, Martin says. "That has allowed new partnererships."

The workshop, funded in part by the California Endowment, was held one month after Gov. Arnold Schwarzenegger announced a $32 million, three-year public-private partnership to train lab techs, dental hygienists, and pharmacy techs.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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