Coronavirus pandemic has heightened longstanding labor shortages in America’s clinical laboratories
Brandy Gunsolus’s staff at the Augusta University Medical Center has expanded laboratory operations to meet the nonstop demand for coronavirus testing. Many of the 23 technologists involved with Covid-19 testing are working overtime, running patient samples and chasing down scarce supplies—all while trying to keep turnaround times low.
Augusta University Medical Center has awarded salary increases to its entire laboratory staff to encourage them to stay on, and some workers have delayed retirement, she said. The center also brought in traveling medical laboratory scientists under contract to help ease the workload. But as the heightened response trudges on, Dr. Gunsolus says she can sense the frustration.
“You might be able to do it for a few weeks or days, but now we’re going into months and months, and there’s no end in sight, said Dr. Gunsolus, who manages the immunology laboratory at the medical center. “We do not have the staff to sustain it.”
As the U.S. has processed more than one million daily Covid-19 tests four times in the past week, the demands placed on laboratories are exacerbating longstanding staffing shortages, lab specialists say. Now, some laboratories are grappling to find solutions to address labor shortages and prevent employee burnout, including hiring traveling laboratory scientists, investing in automation and sometimes flexing schedules or raising salaries.
“They’ve been working really hard, and people are getting burned out,” said David Grenache, chief scientific officer at TriCore Reference Laboratories in New Mexico and president of the American Association for Clinical Chemistry. “I can replace hardware and I can manage not having enough reagents, but I can’t easily replace a qualified technologist.”
Laboratories that don’t have adequate staff sometimes have to limit the amount of testing they can do, which can force them to reduce the types of tests they offer, Dr. Gunsolus said. The shortages could also extend turnaround time for test results.
There are roughly 337,000 clinical laboratory technologists and technicians working in hospital, public-health and commercial labs across the country, according to the U.S. Bureau of Labor Statistics. These medical-laboratory scientists prepare and analyze patient samples, operate highly complex machinery and report out test results. Technologists can perform more complicated tests than technicians and often require more education.
In 2018, the American Society for Clinical Pathology reported an average vacancy rate in U.S. medical laboratories of 8.6%, up from 7.2% the year before, and the need for diagnostic testing in coming years is projected to grow.
Labor shortages in the field have existed for years, medical laboratory scientists say, due to a combination of factors such as low awareness and recruitment and an aging workforce.
Pay is also relatively low compared with other health-care professions with similar education requirements, according to a 2018 report from the American Society for Clinical Laboratory Science, contributing to a flow of workers leaving to pursue other careers. In 2019, the Bureau of Labor Statistics put the median annual salary for clinical laboratory technologists and technicians at $53,000.
When the pandemic hit, many labs expanded their operations into the early hours of the morning and through the weekends. Laboratory scientists worked to validate Covid-19 tests, source scarce reagents and scale up operations on multiple testing platforms.
Labs across the country continue to expand operations, with some new labs opening and scaling up from scratch. That means qualified workers for Covid-19 testing are also increasingly difficult to find, employers say. In August, 58% of labs surveyed by the American Association for Clinical Chemistry listed staffing as an issue, up from 35% in May.
The skill sets required for clinical testing are often specialized and don’t easily transfer from other fields. In some states, such as New York and California, technologists need a state-specific license, though both states waived that requirement at the beginning of the pandemic.
“We don’t have a lot of backfill in expertise,” said Rodney Rohde, chair of the clinical laboratory science program at Texas State University. “You can’t just grab someone and train them up.”
The Orange County Public Health Laboratory in California has three open positions, including one that has been vacant for six months, said laboratory director Megan Crumpler. The lab has set aside its federal Covid-19 aid for use in hiring. But it hasn’t been able to find people to fill the positions, which is also delaying some of the laboratory’s long-overdue IT, training and quality-assurance projects, she said. The lab needed two people to work weekends before the pandemic. Now it needs 11.
“We are constantly scrambling for personnel, and right now, we don’t have a good feeling about being able to fill these vacancies because we know there’s no pool of applicants,” said Dr. Crumpler.
To attempt a workaround, Orange County has trained technologists from other departments, brought on traveling staff and invested in an automated, high-throughput machine to run more samples.
Automating the Covid-19 testing processes can ease labor shortages for the laboratories that can afford to do so or get access to the highly sought-after equipment, laboratory experts say. Dr. Rohde said the expansion of accurate, rapid testing done outside of the lab could also ease the Covid-19 laboratory testing burden.
Connecticut-based genetic testing and health-data analytics company Sema4, which is working with the state on Covid-19 testing, is looking to hire 50 technologists, said Jamie Coffin, president and chief operating officer of the company. People are currently the “No. 1 scaling factor,” he said.
Aureus Medical Group, which employs traveling health professionals, is experiencing the greatest demand for its medical laboratory scientists in its 17-year history of that division, said Matt Neel, director of allied health sales and operations at the company. The demand from clients is outstripping the supply, he added.
The added support from traveling scientists, along with the second Covid-19 testing lab that opened on campus, helped ease the workload for Lauren McDanel and her fellow medical laboratory scientists at Augusta University Medical Center, she said.
Ms. McDanel, who runs Covid-19 tests in the microbiology lab, has been able to dial back her hours and no longer needs to come in for the 2 a.m. shift. But the contract workers are set to leave soon, and she is hoping reinforcements, traveling or permanent, arrive to take their place. “I’m good right now. Ask me again in a week.”