Volume 35 Number 6 | December 2021

Alex Shaw, ASCLS Developing Professionals Forum Councilor-at-Large

Alex ShawAs an MLS student and active ASCLS member, I have become more and more aware of the issues that plague the clinical laboratory. There are many laboratory personnel getting closer to retirement, not enough new graduates ready to fill those openings, and COVID-19 causing many other problems, including collection tube shortages and increases in testing. There may be places that will look to hire non-laboratory professionals to fill the many open positions in their labs. With the theme of advocacy in mind, we must advocate for state licensure as laboratory professionals.

Discussions surrounding state licensure have been ongoing in the laboratory community for quite some time. With recent changes in the Tennessee licensure law, there are currently only 10 states that require laboratory personnel licensure. When a laboratory student graduates from their accredited program, they become eligible to take their board of certification exam. By completing this exam, the student has earned their respective laboratory credentials. Certification may help these new graduates to receive employment in a laboratory but will not directly hold them accountable by law if errors occur. ASCLS explains licensure well with this quote: “If a license is required to practice a profession in a state, it is unlawful to engage in the work without one and the consequences of doing so are very serious.” Why is this important? State licensure will protect the patient.

“Advocating for the laboratory is one of the best ways to showcase our importance and gain more support.”

Laboratory results guide the majority of treatment plans for patients. Because of this, we need to ensure that those in the lab are highly skilled and qualified to be putting out results. In states that don’t have licensure (and if the facility doesn’t require professional certification), facilities may have individuals who did not receive a laboratory education running complex instruments or dealing with complex cases. This poses a significant risk for the patient.

For example, a laboratory hired someone with a general biology degree capable of performing high complexity testing. The lab received a specimen from a suspected CML patient. The ordering physician requested FISH testing for the BCR-ABL fusion gene, and the person with no laboratory certifications accidentally performed this test incorrectly. This person reported the results, and the incorrect results indirectly harmed that patient. If the result were falsely positive, the doctor would likely place the patient on a tyrosine kinase inhibitor, which could cause unwanted anemia or other issues. If the result were falsely negative, correct treatment would be delayed, and their disease would likely progress and cause unnecessary secondary health issues. If the state they practice in had licensure in place, this issue would be less likely to occur. The uncertified person would not be able to practice in the laboratory without proper qualifications, and more importantly, the patient would be protected from these drastic errors.

Many ASCLS members have vast experience in the clinical setting and are well aware of the potential dangers of having underqualified or unqualified individuals performing these tests. But the public may not know these issues. Advocating for the laboratory is one of the best ways to showcase our importance and gain more support.

I strongly encourage all of you to advocate for state licensure laboratory professionals. Inform friends and family about the lack of licensure. Post about it on social media. Discuss it with the hospital administration. And go directly to those who can make change happen—government officials. Write letters, send emails, leave voicemails. Attend meetings and events like the Laboratory Legislative Symposium. The more people we get to advocate the needs of the laboratory, the better. Change can happen, but we must all speak out and advocate!

Alex Shaw is a student at the University of Minnesota-Twin Cities in Minneapolis.