Volume 38 Number 6 | December 2024
A Medical Laboratorian’s Experience in Hospital Vs. Reference Laboratories
Jin Heo, MLS(ASCP)CM, CLT(NY), ASCLS Ascending Professionals Forum Councilor
Andrew Samon, MLS(ASCP)MB, ASCLS Ascending Professionals Forum Councilor
Hello, we are Andrew and Jin, two laboratory professionals who started our professional careers in either a reference or hospital laboratory and have since switched to work in the other style of laboratory. For many medical laboratory professionals, the two most common work settings are either a hospital or reference laboratory. Working in these two similar, but distinct, work environments has helped us realize that both settings serve to provide critical laboratory results, but they differ in many other aspects of the job. Understanding these key differences can help you choose the right path for your individual professional journey and achieve a fulfilling role in your career.
Hospital Laboratory
Hospital laboratories are onsite labs inside healthcare facilities that are able to run tests shortly after sample collection, typically focusing on routine and STAT testing. For most of us laboratory professionals who work in a hospital, the lab is a combination of Mission Impossible and MacGyver, running around with alarms blaring and phones ringing, all the while subduing crying instrumentation with our ingenuity and quick-thinking. Identifying and troubleshooting result discrepancies will be a mainstay of your job and require excellent critical thinking and communication skills. Hospital laboratory professionals thrive in these fast-paced settings, fulfilling the various roles that are called upon them.
Reference Laboratory
Reference laboratories are offsite labs that are usually not included in the health systems of their clients. Patient samples are sent to these laboratories for processing, typically by clinics and doctor’s offices too small to have a lab, or by hospitals that don’t offer some less commonly run assays of a more specialized nature. Working for a reference laboratory feels like being Indiana Jones, exploring the vastness of this country through the samples that were sent from all over, not to mention all the different kinds of esoteric test panels and state-of-the art instrumentation that are not typically found in normal hospital settings. These labs more frequently invest in total lab automation and other high throughput systems to compensate for their increased workload. Reference laboratory professionals are adventurous and are always looking to push the boundaries of laboratory medicine.
“Whether that be the routine, fast-paced environment of the hospital lab or the highly specialized, high volume testing environment of the reference laboratory, both kinds of laboratories serve a profound and critical aspect in quality patient care.”
Key Differences:
- Workload and Test Menu: Hospital laboratories usually focus on routine assays, especially hematology, chemistry, microbiology, and urinalysis. Samples come in from the ED, inpatients, and sometimes outpatient clinics throughout the day, and the volume of samples can vary by the size of the hospital. Reference laboratories typically still offer these routine tests, but they also have more rare, specialized testing, such as molecular, cytogenetic, flow cytometry, and heavy metal testing. They receive a high volume of samples from shipments from clients across the country.
- Work-Life Balance: Hospital labs operate on a 24/7 basis, which means that they offer several shifts and often have options for any style of work schedule, whether that be 09:00-17:00 weekdays or 22:00-10:00 three days a week. They also tend to have opportunities for overtime work for those interested in some extra cash. Hours of operation for reference laboratories vary by lab, but they tend to offer more conventional work schedules.
- Interdisciplinary Cooperation: A major aspect of work in hospital laboratories includes communication with the larger interprofessional team to troubleshoot any issues, discrepancies, or potential sample recollects that come up. Working in these labs makes you feel like you are part of the healthcare team, taking a more hands-on approach to providing care for patients. Reference laboratories, by contrast, are more independent and will focus their efforts on releasing the most reliable results with the samples they were given. These labs are a great choice for the laboratory professional that prefers to focus on the technical work or are not a fan of making phone calls.
Ultimately, both hospital and reference laboratory settings offer their own unique set of challenges and perks. Whether that be the routine, fast-paced environment of the hospital lab or the highly specialized, high volume testing environment of the reference laboratory, both kinds of laboratories serve a profound and critical aspect in quality patient care. Understanding these differences and similarities can help laboratory professionals make the best-informed decision regarding their professional growth.
Jin Heo is a Clinical Laboratory Technologist at the Hospital for Special Surgery, in New York City, New York.
Andrew Samon is a Clinical Laboratory Scientist in Lenexa, Kansas.