Readers Respond

Oct. 1, 2011

One face of suffering

Just wanted to let you know I loved the photo on your August 2011 cover (“Drugs of Abuse Testing”)! To the lay person the man in the photo may look like he's suffering ill effects from taking the drugs in front of him. As someone who is constantly consulted as to whether we should order a Chain of Custody or DOT, a 5, 7, or 10 panel, with or without confirmation, post accident, overdose, pain clinic, or pre-employment, quantitative or qualitative test for which company or physician…I know the man is just a stressed out lab tech trying to sort out all of the confusion! He needs some Ibuprofen!

Thanks again and keep up the good work!

— Mark Vogt, MT(ASCP)
Point Of Care Testing
Galion Community Hospital
Galion, OH
Avita Health System

Editor's note:  Of course, there may be some readers who actually think you are joking….

Generalizations about generations

I had to laugh a little after reading the broad and superficial stereotypes portrayed in the response about multigenerational staff members (“Management Q & A), August, 2011, page 34). It had all the relevancy of daily horoscopes. As for myself, I could pick out things from every category that applied to me. Or didn't.

The last paragraph would have sufficed for the entire answer: “Get to know your staff. Learn what motivates each of them. Make sure they feel appreciated. Reward them sufficiently.” This is the real answer, and obviates any need for HR-approved concepts of who we are based on our age.

— Roy Midyett
Presbyterian Intercommunity Hospital
Whittier, CA

Editor's note:  Generalizations are just that, of course, but they can be useful in approaching the management of individuals. Few could take issue with your point about the validity of the last paragraph of the response.

The right tests for our lab

We are in the process of opening an HLA lab to support our Stem Cell, Kidney and Pancreas Transplant programs. This is done at the request of the transplant docs who want the improved TATs of us doing the testing here.

We are in the process of expanding our Molecular Infectious Disease testing for our Nephrologists and Infectious Disease docs to perform the quantitative PCR for HBV, HCV and HIV. The HCV will be at a lower detection level of <25 IU.

— Leo Serrano, FACHE, DLM(ASCP)
Director of Laboratories
Avera McKennan Hospital and
University Health Center
Sioux Falls, S.D.

Editor's note:  Mr. Serrano's letter is in response to a general call to readers about directions your lab is taking: tests that have “knocked your socks off”; tests you may be considering that would change your lab for the better; or even tests you would invent yourself if you had half a chance! Further responses for upcoming issues will certainly be welcomed.

Another response to “Peg” (June 2010 “Mentoring Minute”)

I would like to suggest yet another approach to labs being appreciated. I “grew up” in the lab profession starting in the mid 1970s, never being recognized, always in the basement, being summoned as “lab” or vampires. The usual.

Now I manage a lab in a Family Medicine clinic with 28 providers. We have a full service lab with traditional analyzers including chemistry, immunoassays, and CBCs as well as some smaller machines and the usual microscope and rapid test kits. We test around 400,000 tests a year. We have 15 lab staff, including techs and lab assistants/phlebotomists. Our techs draw blood and our lab assistants do testing per CLIA requirements.

What is unique to our clinic from my own professional perspective is the organization itself. Our docs are very interactive and openly appreciative of lab staff. We really are a true partner in our patients' healthcare. Our organization adopted a full EMR several years ago, including electronic results, order entry, and charge back to our Practice Management system for billing. If nothing else put us in the picture, that certainly did. Our doctors looked to me to contribute to developing and maintaining these projects. They respectfully ask for help, understanding, changes, suggestions. They have standardized orders and other lab protocols across our clinic and our three other partner clinics that are on the same system.

Our docs know that they can come to us with questions or concerns and we will quickly research it and get back to them. We are always appreciative when they pick up on a problem or possible trend. A few times we have a problem that we can quickly correct. Most times we do not have a problem—just an opportunity to discuss with the doc for better understanding.

We have an excellent executive group, medical director, lab director and administrator who all understand the importance of the lab and are always appreciative and supportive. I work very closely with our business office so that I can speak some CPT and they can speak some lab, in order to maximize appropriate reimbursement. I regularly sit in on our Patient Care doc meetings, sometimes Exec. meetings, and QI meetings. This way I am always there to answer lab-related questions or take requests or suggestions, as well as learn about ways the lab may interact on any particular topic or service.

I also sit on the Education Advisory Board for our local community college for their Phlebotomy and Lab Assistant 1,2,3 programs. They have excellent programs, and we frequently get their externs and hire their graduates.

We have a very good relationship with our reference lab. They work with us on any lab electronic or connectivity projects. They help us with any technical information, answer any questions or concerns, and aren't surprised when I walk in to meet with supervisors or attend meetings.

Our lab staff have been trained to find out “new test” information on their own so that they don't always have to rely on reference lab customer service. They have new employees and learning curves also!

What I'm saying is that I've now worked at all points on the spectrum. I am an old labbie who was in a constant state of disbelief when I kept hearing and reading how the lab has all of this expertise and needs to get out of the lab, mingle, be a more visible and contributing part of its organization. I don't want to get out of the lab. Why don't they come to us? I began to be so much more fulfilled in my profession and happier on a personal level when I finally learned to bag that model.

No, I'm not a Pollyanna. I can be as cynical as the next person. I was just tired of being at the back end of the horse. I wanted to be a part of what was going on, not looked at as a utility. So instead of taking a “let's organize,” “martyr,” or “working in healthcare is its own reward and don't expect anything else” approach, I was given the opportunity to bring as much as I could to the clinic and, in return, everyone in the lab loves working here. And we do have regular direct contact with our patients, docs, nursing staff, and every department. Our expertise is appreciated at our three sister clinics that have the smaller, traditional POL labs. This means that I have been able to help them improve the quality in their labs also.

Does this seem too good to be true? It is if you aren't willing to work at it constantly, continue to learn and grow, reach out to the other people in the organization, and be willing to accept full accountability and responsibility for your lab. And you might also get lucky and find a great organization to make this challenge easier. The more we contributed, the more respected we became. Yes, I'm bragging. I have a group of employees who love their jobs, talk about going to a tech school instead of nursing or radiology, etc. And we tell prospective applicants all of this as well. It's a great recruitment and retention tool. I also believe that if you are in control of your lab, and your organization is aware of all that you bring to the healthcare of your patients, you might just help the lab industry get appreciated on the Hill!

— Deb Troutman, MLS(ASCP)
Lab Manager
Edmonds Family Medicine
Seatttle, WA, Metro area

Editor's note:  You present another point of view from that of “Peg,” and an inspiring one—perhaps an ideal for some, but an ideal worth reaching toward.

More on burn-out solutions

I'm so tired of reading about burn-out and understaffing problems over the past several years (including in your June & Aug. 2011 issues) that I felt I needed to give another perspective, one I haven't seen discussed. I feel I represent many aging-in-place med techs who still want to be part of the laboratory community.

I became ASCP certified as a Medical Technologist in 1969. I passed the California license exam to become a CLT (now CLS) in 1992. I became NCA certified in 1992 as a CLS. I received a certificate from the ASCP BOR in 2009 for recognition of 40 years of Board Certification. I maintain all my credentials. I complete 18 hours of continuing education each year. I read about a dozen medical- or lab-related journals per month. And I officially retired in 2006 after a family relocation.

I've worked at research labs, private independent labs, large and small hospital labs, and even a reference laboratory. I've established, managed, and worked in several POLs. Except for my first position in a large (over 1000 beds) hospital back in 1969, I've always worked the way I wanted: part-time, several hours a day, between 20 and 30 hours per week. I never wanted full days, even if it was just 2 to 3 days per week. I never got burned out and always had time for myself, my family, outside activities, appointments, etc. I was also available to fill in as needed if something unforeseen happened to a fellow lab employee.

After retirement I started volunteering at a worldwide charity that maintains a local presence in my community. Then I found I had more free time and thought I could volunteer at my local hospital laboratory. I met with the lab director and offered to do document control or some other non-technical chores. I thought surely that would be welcomed. Who would have guessed that there was no way to do that! Pink lady, yes; lab volunteer, not so much. They didn't know what to make of my offer. Maybe I was viewed as suspect because I was willing to work for free. Maybe it's a liability or confidentiality issue.

The point is—retired, experienced techs are an untapped resource. Whether it's volunteer work or an official employee/employer relationship, certain part-time positions are nonexistent in most laboratories. Sure, you can find a night shift or weekend job if you are a tech. But there are no jobs these days if you want to work four to six hours per day during the week, between the hours of 8 and 4, especially if it's not five days a week. I think the vacancy rate for laboratory personnel would drop if the shift structure would be more flexible for us more mature professionals who don't want to work an eight-hour shift. I know I would be willing to accept less pay for a more desirable schedule. Job sharing does work! Maybe lab employers will find there is no real personnel shortage after all. Our job titles (Medical Technologist, Clinical Laboratory Scientist, Medical Laboratory Scientist) and the initials we place after our names keep changing (no more NCA). How about changing the work schedule?

One final note: My volunteer position turned into a paying position. I got to pick my schedule—two days per week, five hours per day. And, sadly, I'm not making that much less an hour compared to my last lab job as a med tech in charge of a small hospital's Send-Out Dept.

— Marcia Muller
BS, MLS(ASCP)CM (retired)
Warrenton, VA

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.