Message from the Chair of the Council of Laboratory Professionals
By Lynnette G. Chakkaphak, MS, MT(ASCP)

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While the general public often assumes that health care is a recession-proof industry, I think most people who work in the clinical laboratory field would beg to differ. As director of a system laboratory with more than 200 staff members, I know our laboratory has felt the impact of the economic downturn—and we are certainly not alone.

Like other industries, clinical laboratories have been forced
to tighten their belts during these difficult times. One of the first places this belt-tightening was felt is the availability of capital. The scarcity of capital can probably be traced to the banking crisis and the same types of financial woes plaguing automakers and other industries nationwide.

How does capital funding affect clinical laboratories and the care for patients? Consider the situation of a laboratory with plans to add new molecular testing during the coming fiscal year. The laboratory staff has done all its homework—talked with the vendors, made several site visits, evaluated the work flow impact, and calculated the cost per test. As a result, the staff has selected the system that is right for the laboratory. The laboratory director has submitted a sound proposal showing that molecular testing will provide more sensitive and specific results, lower turnaround times, and improve patient outcomes. In addition, by performing the molecular testing in-house rather than sending it to a reference laboratory, the laboratory will tap into a new revenue stream and cut its referral testing bill.

Although this proposal is convincing, many laboratories in this kind of situation could be disappointed this spring when their proposals are denied by the administration. The funding needed to purchase the necessary equipment simply will not be available. With most institutions having limited capital dollars to spend, the competition for funding will be fierce. New laboratory instrumentation will be forced to compete with highpriced equipment needed by the imaging department or the operating room. This is a competition the laboratory has difficulty winning.

Some laboratories may find a way to include new instrumentation in their operating budgets, in the form of either an operating lease or reagent rental. This option is no guarantee either, however, as some institutions are holding the line on spending by freezing operating budgets at 2008 levels. With possible decreases in both capital and operating budgets, the likelihood of adding new testing modalities is rather bleak. Even the prospect of replacing an essential analyzer in the chemistry or hematology sections could be difficult.

Another by-product of the recession for many clinical laboratories is a reduction in test volume. An American Hospital Association survey conducted in October 2008 showed a drop in patient census numbers at many hospitals. While some Americans have lost their health insurance, others are holding off on non-essential health care. As a result, fewer laboratory tests are being ordered.

Ordinarily, decreasing workloads would be expected to bring the threat of job losses. Fortunately, the nationwide shortage of clinical laboratory personnel will probably buffer the blow of the reduced work volume at most institutions. Many laboratories continue to hire technical personnel, while others are cutting costs by freezing staffing levels or eliminating empty positions rather than laying off staff members.

If there is a bright side to the problems facing laboratories, it could be that the economic crisis is attracting former laboratory professionals back to jobs within the laboratory. Clinical laboratory science program directors and laboratory managers are increasingly hearing from medical technologists, medical laboratory technicians, and others who left the laboratory for jobs in industry, real estate, and other fields. Displaced from their current jobs, they are hoping to get up to speed in order to reenter the field of laboratory medicine. If this trend continues, it may lessen the extent of workforce shortages expected in the years ahead.

Each laboratory faces its own unique challenges as a result of the current economic decline, and I am sure many of you have come up with unique ways of dealing with these challenges. If your laboratory could use some advice or if you have a suggestion that might help another laboratory, please contact me at MemberChair@ascp.org. The Council of Laboratory Professionals and our network of Local and Regional Representatives will do their best to connect you with others.

Ms. Chakkaphak is Laboratory Services Director, St. Vincent’s Medical Center, Jacksonville, FL.