American Association for Clinical Chemistry
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Raising Awareness of Clinical Laboratory Science

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Raising Awareness of Clinical Laboratory Science
Today’s Symposium Discusses Strategies to Add Value, Increase Profile
By Phil Kibak

For many of the almost 20,000 people attending AACC’s 2008 Annual Meeting, raising awareness of the profession is a matter of deep concern. A projected mass exodus of clinical laboratorians due to retirement, coupled with a steep decline of educational programs and younger professionals entering the field, combine to form a “perfect storm” of factors that could greatly affect not only the profession, but healthcare itself. As one laboratory professional said, “As people in the U.S. age and require more and more medical care, wouldn’t it be a shame if the clinical labs couldn’t support the needs of the population?”

But the growing shortage of adequately trained personnel is not the only thing on laboratorians’ minds when considering increased visibility of the laboratory professional. Because clinical lab scientists frequently are overshadowed by the more visible segments of the healthcare community, such as physicians, nurses, and even pharmacists, consumers rarely recognize the value of their work. Additionally, healthcare professionals often regard “the lab” as a faceless entity and not a department staffed by trained and knowledgeable scientists who can provide them with expert assistance.

Today’s afternoon symposium, “Promoting Laboratory Medicine to Physicians, Patients, and Policy Makers” (Room 202B), considers strategies for enhancing the profile of laboratory medicine.

“Even in our niche—in the healthcare and medical community—there’s a general lack of awareness of what laboratorians do and how we impact patient care,” said Nikola Baumann, PhD, Director of Clinical Chemistry and Assistant Professor of Pathology at the University of Illinois at Chicago College of Medicine. “We assure quality lab results and provide expertise in ordering the right test in the right situation and interpreting it correctly. Outside of the healthcare professions, there’s even less awareness of the roles played by clinical laboratory scientists.”

Daniel H. Farkas, PhD, Executive Director of the Center for Molecular Medicine (Grand Rapids, Mich.), a joint venture between Spectrum Health and the Van Andel Institute, agreed. “If people don’t understand what we do, then they don’t value our contribution. And if healthcare professionals don’t value what we do, then there are further ramifications that impact reimbursement and our ability to attract capable people to the field.”

Farkas is chair of the AACC’s Laboratory Information Value Evaluation Advisory Group, assembled earlier this year by AACC President Larry Broussard, PhD, Professor of Clinical Laboratory Sciences at LSU Health Sciences Center, New Orleans. Other members of the panel are Stephen Kahn, PhD, Vice Chair and Associate Director of the Anatomic Pathology Division and Professor of Pathology at Loyola University Medical Center, Maywood, Ill.; Roberta Madej, MS, MT, MBA, Director of Scientific Affairs at Roche Molecular Systems, Pleasanton, Calif.; and Robert Christenson, PhD, Professor of Pathology and Medical and Research Technology at the University of Maryland Medical School, Baltimore. The group is charged with studying this aspect of laboratory medicine and presenting its recommendations at to the AACC board of directors in November.

What Has Been Done

AACC has worked to raise consumer and professional awareness of clinical laboratory science for a number of years. In 1999, the organization initiated the “Health Indicators Five” campaign, designed to raise the visibility of five significant consumer health issues—diabetes, cardiovascular disease, prostate cancer, thyroid disease, and anemia—and of the laboratory tests used to diagnose and monitor these conditions. This initiative grew into Lab Tests Online (www.labtestsonline.org), a highly successful venture that provides detailed descriptions of a broad range of laboratory tests. It is the only Web site devoted solely to laboratory testing that has been developed by laboratory professionals.

In its first full month, in August 2001, Lab Tests Online attracted some 80,000 visitors. Today, the site increases the visibility of the laboratory profession with 1.2 million visitors each month. “People who visit Lab Tests Online can opt to take a survey, and based on those results, we estimate that 75%–80% of visitors are members of the general public—patients or family members—with the remainder belonging to the healthcare community,” said Executive Producer George Linzer.

In the past few years, Lab Tests Online has gone global, giving AACC and the profession some welcome worldwide recognition. It is currently available in the U.K., Spain, Germany, Poland, Hungary, Italy, and Australia, and launches are planned in three other countries—Greece, the Czech Republic, and Portugal.

Encouraging Students

Many students today are unaware that the profession even exists. Paula Garrott, EdM CLS (NCA), Chair of the Coordinating Council on the Clinical Laboratory Workforce (CCCLW), said that a workgroup had been established to develop strategies and create and disseminate effective recruitment and retention materials. “They have been charged with developing promotional materials for middle school, high school, and college students, as well as for adults who are thinking about changing careers,” she said. Garrott also is Director of the Natural Sciences Division and Chair and Professor Emeritus of the Clinical Laboratory Sciences Department at the University of Illinois at Springfield. “But we’re also reaching out to healthcare executives to reinforce to them the value of the services we provide.”

Another program aimed at increasing visibility of clinical laboratory science as a profession among middle-school, high-school, and college students is Labs Are Vital, a recruitment effort designed by Abbott Laboratories (Abbott Park, Ill.). It highlights the critical role that lab professionals play in healthcare. Recently the initiative went digital, using a peer-to-peer recruitment approach including sponsoring a new group and scholarship contest on the online social networking site Facebook.

Dade Behring (now Siemens) also has provided $300,000 per year in scholarship support for students enrolled in CLS and CLT programs. The company has pledged $1.25 million through 2008. The overall level of industry support, although helpful, doesn’t match what other healthcare professions receive. “We’d love to have the kind of industry support that Johnson & Johnson has supplied for the public awareness campaign for nursing, but for now, it just isn’t there,” said Garrott.

Encouraging Young Scientists

In recent years, AACC has stepped up efforts to recruit more students into the field of laboratory medicine, as well as create a special community for new members under the age of 40. Through the Van Slyke Foundation (VSF), AACC promotes a variety of opportunities for young investigators to obtain support money. And in 2004, the Society for Young Clinical Laboratorians (SYCL) was formed to meet the unique needs of AACC’s young and student members.

SYCL also takes issues like the workforce shortage to its members. This is occurring at all levels within the profession, noted Baumann. “The median age of the typical doctoral-level clinical lab director is the mid to upper 50s, which means that many lab directors will be retiring soon,” she said. “When we do outreach at universities through SYCL and speak with graduate students, most of them are not aware that with a PhD and fellowship training, you can go into this field and have a career in laboratory medicine.”

Efforts to Raise Awareness

Results for Life—An ACLA-spearheaded initiative begun in 2006. It uses case studies to illustrate the value of laboratory testing to policymakers. For more information, go to the web site.

AdvaMed Progress You Can See—An educational effort sponsored by AdvaMed to improve understanding of the value of medical technology. For more information, go to the web site.

National Medical Laboratory Professionals Week—Celebrated during the third week of April. This yearly event promotes and recognizes the value of laboratory testing and laboratory professionals. AACC is one of 11 organizations that sponsor the event. For more information, go to the web site.

Grand Rounds and Floor Presence

Baumann also talked about a movement to include lab medicine in grand rounds. “If laboratory medicine residents and fellows can have a presence at these gatherings, it shows the other healthcare services how we make a real and direct contribution to patient care.”

“The fact that laboratory personnel have no direct contact with patients is a disadvantage. Our customer usually is the clinician, so we need to use that interface and make our role known to the day-to-day healthcare providers,” she added. “It’s our responsibility to make our professional colleagues aware of what we do.”

Physicians do come into the lab to consult about the meaning of a test result or with other questions about the myriad tests available. But clinical lab scientists say they need to have a presence on patient floors. Garrott noted that some hospitals and medical centers have begun linking the lab with various hospital units like the ICUs by placing clinical lab scientists as liaisons to those departments. Some labs also have instituted the practice of having a clinical lab scientist, rather than a clerk, answer phones to troubleshoot and answer questions.

A High-Stakes Situation

“The shortage of clinical lab scientists has not garnered as much attention as the nursing shortage, but the stakes are extremely high,” Garrott remarked. In some educational programs, she added, faculty and curriculum developers are beginning to focus more on the role of the clinical lab scientist as a consultant. “Clinicians tell us all the time they need help to sort through all of the lab tests that are available. Clinical pathologists can do that but in many cases there may not be a staff pathologist or the pathologist is only available for limited hours or days. So in some cases that role may be filled by non-physician clinical lab professionals. As we continue to do that, we gain greater visibility to the healthcare team.”