| #1
|
By a recent (Jan. ‘00) count at the HCFA
there are;
|
|
|
170,926
|
|
clinical laboratories countable under the authority of CLIA’88
|
|
|
96,701
|
|
of them are POL’s
|
|
|
70 %
|
|
not directly regulated (various personnel and other waivers)
|
|
|
90 %
|
|
of laboratories perform < 10,000 tests / year
|
|
|
|
|
- POL’s
- Small / rural hospitals / clinics
- Small private lab
|
|
|
|
|
| #2
|
The fiscal impact of our field is approximately;
|
|
|
7.25 billion tests performed annually (1999
est.)
$14.00 = average cost (1997 est.)
therefore we are a $101.5 billion dollar businessembedded in a $ 1.2
trillion dollar business (general U.S. health care) thereby representing
as much as 11¢ of each health care dollar
|
|
|
|
| #3
|
The BLS (Bureau of Labor Statistics) estimates;
|
|
|
17 %
|
|
growth rate in our field
|
|
|
14.4 %
|
|
for all U.S. jobs
|
|
|
5-13 %
|
|
actual vacancy rate in U.S. labs - 1988 *
|
|
|
9-20 %
|
|
actual vacancy rate in U.S. labs - 1998 *
|
|
[* = From Castelberry,
B.M., and Wargelin, L.L., ASCP Vacancy Rate Data,
Lab. Med.30:174-8,1999]
|
|
|
|
|
|
| #4
|
For the period 1998 - 2008 the BLS projects;
|
|
|
53,000
|
|
new jobs in our field
|
|
|
40,000
|
|
vacancies (retirements, leaving the field, etc.)
|
|
|
93,000
|
|
incremental positions to be filled
|
|
|
9,000
|
|
per year
|
|
|
4990
|
|
graduates from all of our schools (NAACLS est. for
1999)
|
|
|
|
|
|
| #5
|
Data from SSCLP I - ASM Vacancy rates
|
|
|
(current from ClinMicroNet survey of June, 2000)
|
|
|
| Northeast
|
7.5 %
|
| Southeast
|
8.8
|
| Northcentral
|
7.4
|
| West
|
6.4
|
| U.S.
|
7.9
|
|
|
|
|
|
|
| #6
|
The tens of millions (33.6 according to To Err
is Human - National Academy Press, 1999) of patients admitted
to U.S. hospitals each year and the millions more who have laboratory
tests performed in other locations and for other purposes expect a
certain level of quality. The professional organizations in our field
feel a certain custodial responsibility for dealing with this situation.
|
|
|
| #7
|
This sense of responsibility perhaps made sharper in
definition by the events following from the passage and signing into
law of P.L. 100-578, the Clinical Laboratory Improvement Amendments
of 1988. This modification of section 353 of the Public Health Service
Act seemed innocuous at first and focused on technical matters of
standards and personnel. In fact it significantly altered the foundation
upon which our practice field was built. In the intervening dozen
years we have found ourselves in a huge fish bowl with not only the
hundreds of thousands of clinical laboratory professionals but also
regulators, manufacturers, researchers, public health officials and
many others. We have endured the trials and tribulations of the acts
of Congress, the marketplace and reimbursement realities.
|
|
|
|
|
|
| #8
|
There do seem to be some knowable reasons for the instability
in our pool supply;
|
|
|
- Salary
- Stressful working conditions
- Opportunity for advancement
- Availability of desired working conditions
- Image of the profession
- Risk of infectious disease
- Legal liability
|
|
[reported at the CLIAC meeting
of April 2000 from Greenberg, L., Report to Congress on
Shortages of Clinical Laboratory Technologists in
Medical Underserved and Rural Communities,
1993]
|
|
|
|
|
|
| #9
|
Components of problem being identified (Example of one
work group)
|
|
|
| IMAGE/PUBLIC RECOGNITION
|
GENERATION X, Y
|
| TRANSITION/DYNAMIC OF PRACTICE/HC
|
SALARY
|
| NOW VS. LATER, LONG TERM
|
TECHNOLOGY
|
| MANAGEMENT ORIENTED CURRICULUM
|
AGING WORKFORCE
|
| DECREASED SCIENCE INTEREST
|
RETENTION
|
| SCOPE OF PRACTICE (limited vs.
expanded associated associated curriculum)
|
| DECREASED CLINICAL SITES
|
DANGER!
|
| FUNDING FOR PROGRAMS AND STUDENTS
|
| DEMANDS OF ED PROGRAM
|
EDUCATION/PROFESSION
|
| REGULATORY ISSUES/COMPLIANCE
|
OTHER OPPORTUNITIES
|
| MARKETING TO PROSPECTIVE STUDENTS
|
| SELF-SELECTION OF PERSONALITY PROFILE
|
|
|
|
|
|
|
| #10
|
Those components grouped (Example of one work group)
|
|
|
- EDUCATION
- TRANSITION (combined) HEALTH CARE
- RESOURCES - FINANCIAL
- HUMAN RESOURCES
- TECHNOLOGY
|
|
|
|
|
|
| #11
|
Draft solutions proposed (Example of one work group)
|
|
|
EDUCATION / ESSENTIALS
- Redefine Essentials
- NCCLS Summit in September
- Establish different tracts for 4 yr. MT/CLS programs
- 1st two years = Med Tech Core Curriculum
- 3rd & 4th years = more advanced MT/CLS classes
- [concentrations] - Mgt.
- - Information Systems
- Crosstraining
- Value added restructuring of MT/CLS training to better prepare
the professional laboratorian to respond to clinical concerns.
IMAGE
- All organizations should pool resources
- Promote the Profession
ex. Web site open to the public to respond to concerns regarding
what lab tests mean.
- Start promoting the profession at the grade school level in
5th-6th grade.
- Develop Education Module for use by K-12 teachers - all organizations
should participate.
- Go for Grant money to accomplish some of these goals.
|
|
|
|
|
|
| #12
|
The chapter headings of a DRAFT Strategic Plan identified
|
|
|
I.
|
Data Collection
|
|
|
|
* to know where we are
|
|
|
II.
|
Marketing
|
|
|
|
* to attract young people to the field
|
|
|
III.
|
Recruitment
|
|
|
|
* early K-12, compete with other science disciplines
for the "science-minded"
|
|
|
IV.
|
Financing of Education
|
|
|
|
*support to fund scholarships, examine the whole structure
of health professions education costs and their accounting, find our
what the students need
|
|
|
V.
|
Profession in Transition
|
|
|
|
* what will professionals in this field be doing in
the next 7 yr.? * based on the above, how many do we attempt to prepare,
for what rolls
|
|
|
VI.
|
Cooperation
|
|
|
|
* how do we enlist the initial and continuing support
of our fellow professional organizations (represented at the Summit
and others) , philanthropic sources, governmental agencies (CDC,
FDA, CLIAC, HRSA, etc.), educational institutions (colleges, hospitals,
etc.) and others in bringing sustained and effective effort to bear
on this matter ?
|
