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Healthcare Profession-Medical TechnologistHR Experiential Exercise: Chapter 4Suzanne Celmer-HarterLDR 625-OASeptember 16, 2016Dr. John Fick, FACHEHealthcare Profession-Medical TechnologistMedical Technologists (MTs), now known as Medical Laboratory Scientists (MLS), are healthcare professionals that specialize in laboratory medicine. MTs/MLS performs testing on blood and body fluids and gathers data for the clinician to provide them with relevant medical information on their patients that allows diagnosis and treatment. The ability to provide a clinician with patient information is imperative to quality healthcare. Cowan (2005) estimated “70% of the objective information used in the management of patients comes from pathology laboratories” (as cited in Pantanowitz, Henricks, & Beckwith, 2007, p. 823). In addition, MTs/MLS use “laboratory procedures including very sophisticated analyses, but also evaluate/interpret the results, integrate data, problem solve, consult, conduct research and develop new test methods” (American Society for Clinical Laboratory Science, 2016, para 2).According to Delwiche (2003), the history of Medical Technology dates back to ancient Greek times when Hippocrates examined human body fluid. Ancient Egyptians also diagnosed diabetes mellitus by recognizing that urine from those patient attracted ants and tasted sweet to the physician (Ridley, 2011). The first clinical laboratory was opened in 1896 at John Hopkins Hospital. The role of the laboratory and its staff became prominent in the late 1890s after “devastating” outbreaks of “epidemics such as tuberculosis, diphtheria and cholera” (p. 303). The earliest medical technologists were women who were trained by physicians to be assistants. In 1922, the American Society for Clinical Pathologists (ASCP) was created, and the first certification exam was given in 1928 (ASCP Board of Certification, 2016). “In 1930 when the ASCP issued the first certificates of registration, the requirements consisted of graduation from high school, completion of one year of didactic work, and completion of six months of experience in a recognized laboratory” (Delwiche, 2003, p. 304). Although Board of Registry approved schools developed, and the length and type of education progressed from high school to college programs, many early medical technologists were trained on the job. When certification of the profession became prevalent in the 1960’s and 1970’s, most of the MT’s were “grandfathered” into certification through an exam given by HEW (Health Education and Welfare). In the 1960s, specialty certifications were recognized in chemistry, microbiology, hematology, and blood bank. Master’s and doctoral programs became established to train individuals for faculty positions to teach future MTs (Delwiche, 2003).Students with an interest in Medical Laboratory Science should have a high school background and interest in mathematics, biology, and chemistry. Depending on the college or university, the first two years of study are based on these subjects along with other general education classes required for graduation. Sophomore or junior status students apply to a National Accrediting Agency for Clinical Laboratory Sciences (NAACLS) approved program. There are 232 NAACLS approved programs in the United States that ensures MLS programs are at a “high standard” and have requirements including:The curriculum must address pre‐analytical, analytical and post‐analytical components of laboratory services. This includes principles and methodologies, performance of assays, problem‐solving, troubleshooting techniques, interpretation, and evaluation of clinical procedures and results, statistical approaches to data evaluation, principles and practices of quality assurance/quality improvement, and continuous assessment of laboratory services for all major areas practiced in the contemporary clinical laboratory. The program curriculum must include the following scientific content: a. Clinical chemistry b. Hematology/Hemostasis c. Immunology d. Immunohematology/transfusion medicine e. Microbiology f. Urine and body fluid analysis g. Laboratory Operations. (NAACLS, 2016, pp. 14-15)Upon completion of academic requirements, students must complete a didactic six-ten month clinical internship at an approved laboratory in all areas listed above. Many colleges and universities offer internship with affiliated hospitals or commercial laboratories. However, some MLS programs require the student to match or find a program on their own after graduation. Collective goals of a MLS program are education and preparation for certification examination to produce an individual capable of performing medical laboratory testing. The preferred national certification agency is American Society for Clinical Pathology (ASCP), which was established in 1928 and is known as the “gold standard” and “is sought out by seven times as many laboratory professionals as any other lab professional credentialing organization” (ASCP Board of Certification, 2016, para. 1). Other certifying agencies include American Medical Technologists (AMT) and American Association of Bioanalysts (AAB). There are currently 11 states with laboratory personnel licensure (California, Hawaii, Florida, New York, North Dakota, Tennessee, Louisiana, Nevada, West Virginia, Montana, Georgia). Puerto Rico also has licensure. The components of the law vary state-to-state, but usually include an annual licensing fee (some are bi-annual), a provision for continuing education, a minimum education and professional competency requirements. (American Society for Clinical Laboratory Science, Personnel licensure, 2016, para. 2)Opportunities for employment include hospitals, commercial laboratories, physician offices, academic laboratories, pharmaceutical, biotechnology, and manufacturing companies throughout the United States and worldwide (Bureau of Labor Statistics, 2015; Ridley, 2011). Vertical differentiation of Medical Technology starts with education, clinical internship, and certification. Another route includes a lesser two-year Medical Laboratory Technician (MLT) degree with a simpler scope of practice. MLTs perform testing that has been deemed as less complex, moderate as opposed to high complexity by CLIA 88 regulations, are not allowed interpretation/evaluation of results, and are supervised by MTs/MLS (Ridley, 2011). Many MTs/MLS are choosing to start their careers as MLTs and then progress to a MT/MLS degree. MTs/MLS may continue to choose promotion and advance into manager or director positions. Advanced degrees include a Master’s of Science in Clinical Laboratory Science, Molecular Biology, Public Health, and Health Administration, as well as other business or management fields. As of 2012, Rutgers University began to offer a Doctorate in Clinical Laboratory Science (DCLS) as an advanced practice degree “which prepares medical laboratory scientists to assume expanded roles as integral members of the interprofessional healthcare team in a variety of practice settings” (Doctorate in clinical laboratory science, 2013, para. 1). The advanced laboratory degree prepares individuals to participate in a consultant capacity within a patient care team such as recommendations for test utilization to physicians and development of clinical pathways for diagnosis. Other opportunities for Medical Technologists that are in direct competition are a graduate degree as a physician assistant or entry into medical school. The field loses many MTs/MLS to these two pathways because the scientific and medical background makes the individuals excellent candidates for these careers. According to the Bureau of Labor Statistics (2015), the number of professionals in practice nationally is 162,950. The states that have the highest employment level of Medical Technologists are Texas, California, Florida, New York, and Pennsylvania. Metropolitan areas, particularly in Northeastern United States, Chicago, Los Angeles, Houston, Atlanta, Baltimore, Dallas, Washington DC, and Tampa/St. Petersburg are the most populous areas for employment of Medical Technologists. Rural and non-populous areas of Nevada, Utah, Montana, and New Mexico are sections of the country that have the least number of Medical Technologists employed.The current strategic issues that Medical Technologists face are lack of students into the undergraduate programs and retention of graduates within the first few years after graduation. Reasons for the exodus and lack of recruits are salaries not comparable with other medical professions, lack of recognition of the profession, high workload, and stress levels, and training can lead to other lucrative professions that pay more and have more respect (Kibak, 2008). In addition, the average age of Medical Technologists is approximately 50 years, and many individuals will be retiring within the next decade (Robinson, 2013). Supporting the vacancy issue is the fact that current statistics from BLS show the job growth outlook from 2014 – 2024 for clinical laboratory scientists is forecasted to be an increase in 16%, which is higher than the average growth rate (Bureau of Labor Statistics, 2015). Medical Technology is a great profession for those who are interested in science and mathematics and want to work in healthcare without direct patient contact. The contribution of Medical Technologists is significant to patient diagnosis and treatment. Growing the profession by introducing students to the profession at an early age, along with paying competitively, making MTs/MLS feel valued, and part of the healthcare team and utilizing technology to support workload are some of the ways that vacancies will be countered.ReferencesAmerican Society for Clinical Laboratory Science. (2016). Career center: What is a medical laboratory science professional. Retrieved September 13, 2016, from The American Society for Clinical Laboratory Science: Society for Clinical Laboratory Science. (2016). Personnel licensure. Retrieved September 13, 2016, from American Society for Clinical Laboratory Science: Board of Certification. (2016). Retrieved September 10, 2016, from American Society for Clinical Pathology: of Labor Statistics. (2015). Occupation outlook handbook: Medical and clinical laboratory technologists and technicians. Retrieved September 7, 2016, from Bureau of Labor Statistics: , F. A. (2003). Mapping the literature of clinical laboratory science. Journal of the Medical Library Association, 91(3), 303-310. Retrieved September 11, 2016, from in clinical laboratory science. (2013). Retrieved from Rutgers School of Health Professionals: , P. (2008). The worsening shortage of lab staff. AACC Clinical Laboratory News, 34(5), 1-4. Retrieved September 6, 2016, from . (2016). NAACLS standards for accredited and approved programs. Retrieved September 13, 2016, from , L., Henricks, W. H., & Beckwith, B. A. (2007, December). Medical laboratory informatics. Clinics in Laboratory Medicine, 27(4), 823-843.Passiment, E. (2006). Update on the laboratory workforce-shortage crisis. Medical Laboratory Observer, 38(3), 64-65. Retrieved September 05, 2016, from , J. W. (2011). History and development of medical laboratory science. In Essentials of clinical laboratory science. Clifton Park: Delmar, Cengage Learning.Robinson, M. (2013). UB medical technology graduates fill growing national shortage. Retrieved September 9, 2016, from University at Buffalo: ................
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