Since 1988, the American Society for Clinical Pathology (ASCP) has conducted its Vacancy Survey to determine the extent and distribution of workforce shortages within the nation's clinical laboratories. This confidential survey has been administered every 2 years and has served as the primary source of information for academic, government, and industry labor analysts. Results from past surveys show that laboratory medicine is a rapidly evolving field. Although ASCP recognizes the importance of continuity, each time the Wage and Vacancy Survey is administered represents an opportunity to improve its methodology to collect the most current relevant data while maximizing survey participation. The survey has evolved in response to changes within the profession; new questions were added to the 2012 survey to examine some of the factors affecting wage and vacancy rates. ASCP continues to gather questions, comments, and suggestions from our members regarding the profession, with the goal of adressing them through this important survey.
The 2012 Vacancy Survey was conducted through collaboration between ASCP's Institute of Science, Technology, & Policy in Washington, DC and its Educational Design and Technology division and Board of Certification in Chicago, IL.
Electronic survey invitations were sent on July 25, 2012, via Survey Gizmo (an online survey vendor). The survey was closed on August 31, 2012. This year, ASCP also used social media (ie, Facebook and LinkedIn) to disseminate the vacancy survey to help augment the response rates.
The main goals of this year's vacancy survey were to address the following:
Vacancy rates by laboratory department
Anticipated vacancies in the next 6 months by laboratory department
Rates of vacant positions left open for longer than 6 months
Anticipated retirement rates in the next 24 months by laboratory department
The 2012 Vacancy Survey sought to collect staff- and supervisory-level data on the following laboratory areas:
Anatomic pathology (including non-MD professionals)
Core laboratory (new laboratory area surveyed this year)
Laboratory safety (new laboratory area surveyed this year)
Molecular biology/diagnostics (new laboratory area surveyed this year)
Reproductive medicine and genetics (new laboratory area surveyed this year; sample sizes did not allow for statistically significant comparisons)
Specimen processing (new laboratory area surveyed this year)
Tissue typing/histocompatibility (new laboratory area surveyed this year; sample sizes did not allow for statistically significant comparisons)
Administration (new laboratory area surveyed this year)
The ASCP survey administrators recognize that there is no standard approach to how laboratories are organized; laboratory areas may hire staff with a variety of certifications. ASCP provided survey participants with the opportunity to report on the certifications that exist or are sought after for the laboratory area under their supervision.
The primary objective of this research was to estimate the rate of shortages within clinical laboratory departments. Overall, this survey presents data from 935 respondents responding for 22 842 employees across the United States. Of all the departments surveyed, the phlebotomy, blood bank, core laboratory, hematology/coagulation, microbiology, chemistry, histology, and specimen-processing departments employ most clinical laboratory personnel. By region, the Far West region (composed of Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming) had the highest response rate at 22.2%. The Central North West region (composed of Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota) had the least number of respondents at 9.7%.
Across the nation, the vacancy rate was highest for phlebotomy departments (8.0%) and lowest for the cytogenetics, histology, and immunology departments, as well as laboratory safety personnel (4.0%) (Figure 1). According to the survey results, phlebotomy (8.0%) has the highest overall staff (nonsupervisor) vacancy rates in the nation; specimen processing (14.0%) has the highest overall supervisor vacancy rates (Figure 2 and Figure 3) The lowest staff (nonsupervisor) vacancy rates occurred in the departments of cytogenetics, laboratory safety, and specimen processing (each 4.0%); the lowest supervisor vacancy rate was in the immunology department (1.0%; Figures 2 and 3).
Survey findings show that immunology departments have the highest overall percentage (10.0%) of employees anticipated to retire in the next 24 months. Cytogenetics and phlebotomy have the lowest rate of employees expected to retire in the next 24 months (4.0%). The projected retirement rate is highest for staff (ie, nonsupervisory roles) in the immunology department (10.0%) and lowest in the phlebotomy department (3.0%). The supervisory retirement rate is highest in the hematology/coagulation department (24.0%) and lowest in the histology and molecular biology/diagnostics departments (4.0% for each).
Overall, survey results show that molecular biology/diagnostics and phlebotomy have the highest percentage of positions (8.0%) anticipated in the next 6 months (by December 2012) and chemistry/toxicology has the lowest rate of anticipated positions (0.4%). Data also reveals that chemistry/toxicology has the highest percentage of vacancies left open for more than 6 months. By region, the Central South West (composed of Arkansas, Louisiana, Oklahoma, and Texas) and Far West (composed of Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming) reported higher vacancy rates than other regions; by contrast, the Central North West had the lowest vacancy rates.
Current Laboratory Workforce
Compared with the results of ASCP's 2010 Vacancy Survey, this year's results reveal decreased overall vacancy rates for blood bank, cytology, hematology/coagulation, histology, immunology, and microbiology departments (Figure 1). Data also show a slight decrease in staff (ie, nonsupervisor) and supervisor vacancy rates by department except for the cytology department, whose staff vacancy rate has doubled since 2010 (Figures 2 and 3). Overall, the rate of certified laboratory professionals is up this year. Hematology/coagulation and histology departments reported a slight decrease in the rate of certified staff (nonsupervisor); the numbers of certified staff (nonsupervisor) and supervisors decreased this year for microbiology compared with the findings of the previous year's recent Vacancy Survey.
This year, the Vacancy Survey asked about the total positions anticipated to open in the next 24 months due to personnel retiring. Results show that the projected retirement rate for supervisors is higher than that of staff (nonsupervisor). Comparing the anticipated vacancies between June and December 2012 among all the departments surveyed, staff rates are generally higher than supervisor rates. The number of staff positions that take longer to fill (ie, have been left open for more than 6 months) is highest for the molecular biology/diagnostics department and the blood bank. The cytology department has the lowest rate of unfilled positions after 6 months.
Results of the 2010 ASCP Vacancy Survey report showed that, overall, the most difficult work-shift position to fill was the night shift. In addition, the previous report also pointed out that the immunology and phlebotomy departments had also reported difficulties in hiring for the day shift. This year's survey results, however, reveal that, overall, laboratory departments are not experiencing difficulties in hiring staff regardless of the type of work shift. At the staff level, most laboratories filled most positions within less than 3 months of posting. Supervisor positions were filled within 3 to 6 months after posting.
The rise of new technologies in the field of laboratory medicine prompted ASCP to ask if this has affected staffing in laboratories. Approximately 72.8% of participants indicated that new technologies have not caused changes to their staffing needs. Those who are affected by new laboratory technologies, however, reported that while it potentially decreased the need to have as large a staff, the number of tests and the workload have increased. Some of the new technologies mentioned were molecular testing, automation, flow cytometry, genetic testing, and immunohistochemistry (IHC).
This year, the ASCP Vacancy Survey included information on 7 new departments (administration, core laboratory, laboratory safety, molecular biology/diagnostics, reproductive medicine and genetics, and tissue typing/histocompatibility) in addition to the 10 laboratory areas surveyed in 2010. Vacancy rates are at least 2% lower for staff (nonsupervisor) and supervisor positions this year compared with 2 years ago. The economy, the aging workforce, innovations in science and technology, and laboratory program closures appear to be contributing factors in the current status of the laboratory workforce.
The current state of the economy poses a challenge in the clinical laboratory field. Ease in staffing regardless of work shift suggests that laboratorians are accepting shifts that used to be difficult to fill to earn additional income or that facilities are asking their employees to work those shifts to save costs.
Higher retirement rates for supervisors compared with staff suggest that managers tend to be older than their staff. Further, the current vacancy survey results indicate that there is a higher rate of anticipated vacancies in the next 6 months (ie, by December 2012) for staff than supervisors. The assumption that the retirement of Baby Boomers will lead to an increase in vacancies for younger workers has not yet happened, due to variations in the labor market. A report published by the Robert Wood Johnson Foundation1 states that the economic downturn has “created pressure on health care professionals to revise their career and retirement plans.” Even with a current unemployment rate of 7.8%, the lowest since 2009, it appears that many laboratory professionals nearing retirement age now tend to stay longer in their jobs due to economic uncertainties.2,3
The growing demand for medical care for an aging population is driving the fast-paced advances in medical technology and the explosion of higher laboratory test volume. Although these factors may redefine the workforce skills necessary to meet the demands of tomorrow's laboratory, they have not reduced the need for qualified laboratory professionals. Many of this year's survey respondents indicated that program closures and limited programs available in colleges and universities have led to difficulties in finding qualified laboratorians.
Lack of laboratory expertise among new graduates, lack of recognition as health care professionals in the field of allied health, and lower compensation for laboratorians compared with other health care professionals appear to be contributing factors in the current shortage of well-trained and qualified laboratory personnel. Planning a systematic strategy to address these issues is needed to ensure that the profession can achieve increased visibility and opportunities for advancement in the future.
Andrea Bennett, MPH, MT(ASCP)–ASCP Institute of Science, Technology, & Policy, Washington, DC
Matthew Schulze–ASCP Institute of Science, Technology, & Policy, Washington, DC
Patricia Tanabe, MPA, MLS(ASCP)CM–ASCP Board of Certification, Chicago, IL
Mark Bailey, MA, HTL(ASCP)CM–The University of Texas MD Anderson, Cancer Center, Houston
Barbara Caldwell, MS, MT(ASCP)SH–Clinical Laboratory Services, MedStar Montgomery Medical Center, Olney, MD
JoAnne Edwards, MEd, M(ASCP), MLS(ASCP)CM – Consultant, Joint Commission
Phyllis Walker, MS, MT(ASCP) SBB, Consultant
James Wisecarver, MD, PhD, FASCP–Clinical Laboratory & Molecular Diagnostics, Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha
Sue Zaleski, MA, SCT(ASCP)HT–Department of Pathology, University of Iowa, Iowa City