Readers Respond

Aug. 1, 2011

Find molecular Dx studies/certs

The June 2010 letters (p. 6) featured one from Alison Ide-Smith, who had several questions that were not answered. I was an MLT for many years and went back for my bachelor's degree in CLS, graduating in 2009. Medical technologists do perform the types of testing described. Furthermore, after a required amount of experience, the technologist may test with ASCP for a specialist certification in molecular diagnostics. These technologies are part of the MT/CLS curriculum, both in theory and practice. I had a class in molecular diagnostics/genetics and a required short clinical rotation in a molecular diagnostics lab. I have no information on how to find out about these jobs or the pay scale. I hope this helps.

—Marsha Nelson, MLS(ASCP) Fairview University Medical Center-Mesabi Hibbing, MN

Editor's note: 
Ms. Ide-Smith might consult ASCP or other CLS organizations listed in our CLR 2011-2012 that certify laboratory personnel. We thank Marsha Nelson for her letter and hope Ms. Ide-Smith is reading this response, too.

Burn-out: symptoms vs. solutions

In your June 2011 issue (“Management Q&A, pp. 30-31), you talked about how to minimize the effects of “burn-out” on employees but failed to address the problem, not the symptoms. The writers stated that they were constantly understaffed and unable to take time off because of the need to fill in for the shortages. No matter how many tips you give to deal with burn-out, the core problem remains.

The staffing shortages that are mentioned are usually caused by two factors. The first is a shrinking pool of qualified personnel to replace those that leave or to staff for increased work volume. The second reason is what I believe to be a larger factor and that is the intentional understaffing of the laboratory. As reimbursements fall, managers are under pressure by owners to cut costs — and the biggest cost is labor. Many labs are staffed with the bare minimum of labor needed to get the work out; and when someone is out, the remaining staff has to fill in. When you have vacations, illnesses, retirements, and resignations, this leads to a never-ending cycle of mandatory overtime and employee burn-out. Most medical technologists are loyal and hard-working employees. Treat them as such, and staff the laboratory to meet the needs, not the budget.

—Raymond Wassel, BS, MT(ASCP) Technical Supervisor Family Care Medical Group Clinical Laboratory Syracuse, NY

Editor's note: 
Thank you to Mr. Wassel for his comments, and for his 39 years of experience as a medical technologist! He was not the only person with thoughts about “burn-out” vs. “understaffing.”

Burn-out solutions suggested

I think that the respondents did a great job of outlining some immediate steps for the overworked employees in the questioner's lab (“Management Q&A, pp. 30-31). Management, however, has a much more serious, long-term responsibility to the employees. If the lab is “constantly short-staffed” and employees “often work overtime,” it is time for management to take a hard look at workflow and staffing. The application of LEAN principles — particularly the reduction of waste (useless steps and processes) can often free up time.

Is your laboratory trying to do too much? Review utilization and determine if lower volume tests can be moved to a reference lab (the input of the medical director is critical here to avoid outsourcing assays that are critical to your clinicians). Remember to include the cost of overtime in your analysis.

Do a detailed workload and cost-benefit analysis of using overtime to complete work vs. hiring new employees. Take hard data to your administration to justify new positions. You can do a simple test count month over month or year over year to determine if you have an increase in workload.

Consider utilizing lower-cost (and easier to find) lab assistants or train phlebotomists to be lab assistants to take some of the load off your technical staff. This can also be a “career ladder” for your phlebotomists who, otherwise, might leave you. With appropriate training, lab assistants can load and unload analyzers, aliquot specimens, plate cultures, perform basic instrument maintenance, and many other tasks.

Burn-out is a serious issue, but there are steps, both short- and long-term that can be taken to fix the problem.

—Juliana Hospodor, MBA, BS, MT(HHS) Director, Outreach Operations UMass Memorial Medical Center Laboratory Worcester, MA

Editor's note: 
Perhaps Ms. Hospodor's suggestions can help lab “burn-outs” and their supervisors work a “turnaround” on this issue. Burn-outs should start at once to put an end to the problem, not just address its symptoms as Mr. Wassel pointed out earlier.


Concerning the July 2011 article “Achieving a LEAN Lab” by Tracy Gambrell, (p. 30) in the first paragraph: “… labs feel the need to increase turnaround time.” Aren't we trying to decrease TAT?

—Linda Hendricks, Ithaca, NY

Editor's note: 
We love readers like Ms. Hendricks who find our errors, but we love not making errors even more. This statement was in the original document we received, but we failed to catch this quite obvious mistake. We have apologized to Ms. Gambrell and her representatives, and have corrected this online and in our digital version.

MLO welcomes letters to the editor. We ask that you include a phone number for verification. While we prefer to publish the writer's name, we will publish a letter with “name withheld by request,” but our editorial staff must have the writer's name confirmed for our files. MLO reserves the right to edit any letter for style and length.