ASCP Wage 2019 Wage Survey Report: A Call for Increased and Stronger Advocacy

Numerous newspapers and academic journal articles have recently extolled the importance of laboratory professionals, not just because of the central role they are playing in identifying SARS-CoV-2, but also because of the diagnostic and screening work they perform to identify other diseases and conditions, as well as identifying more appropriate therapeutic regimens, as needed. The strains on the profession caused not just by the COVID-19 pandemic and the need for increased testing capacity but also by years of personnel shortages have been incalculable. These strains lay bare the urgent need to refocus on addressing the challenge that will shape the future of the laboratory profession for years to come.

Earlier this year—and before the arrival of the COVID-19 pandemic—the United States Bureau of Labor Statistics (BLS) estimated the average growth rate for all occupations at 4 percent for the years 2019-2029.¹ But for medical laboratory scientists and technicians, BLS estimated the growth rate at 7 percent—almost double the rate of other occupations. Not surprisingly, the COVID-19 pandemic has upped the demand for qualified laboratory professionals. COVID-19-related testing has prompted a massive increase in test volumes. The health information technology company XIFIN recently reported that the Lab Volume Index, a measure of billing volume data against a baseline volume, indicates that current testing volumes have more than doubled since the start of the pandemic—all with little increase in the overall laboratory workforce.² Clearly, America needs more laboratory professionals as the current workforce is already stretched thin dealing with the need for increased testing.

With this as backdrop, there is some good news that wages for laboratory professionals are increasing, at least for most.

Recently, the American Journal of Clinical Pathology released the 2019 ASCP Wage Survey for Medical Laboratories in the United States. ASCP has been monitoring the laboratory workforce through its main studies, the Wage and Vacancy Surveys for more than 30 years. This most recent survey, conducted prior to the COVID-19 pandemic, resulted in 19,397 responses, a 33 percent increase in participation compared to the 2017 wage survey. The average age of laboratory personnel who responded to the survey is 42.38 years compared to 42.89 years in 2017. Distribution of respondents by age group show that majority of the respondents are in the 25 to 34 years old range at 29.49 (Figure 1). Results from this report show an increase in wages for most of the laboratory occupations surveyed (Figure 2). Salaries are up for all staff-level laboratory professionals except CT, CLA/MLA, MT/MLS/CLS and CG, which have a -0.36%, -0.62%, -0.72% and -5.44% change in hourly wage, respectively, after adjusting for inflation.³ Supervisors’ hourly wages are also up compared to 2017, with the exception of MLTs/CLTs and HTLs at -0.63% and -5.12% respectively.³ Geographically, laboratory professionals from urban areas tend to earn more compared to the rest of the overall laboratory workforce (Table 1).

The survey results also exposed areas of concern that need to be addressed. The survey asked respondents to provide general comments on their profession. ASCP received a total of 3,891 comments and found that 45.18% of respondents expressed concerns of being underpaid/underappreciated, especially compared to nursing and other allied health professions. In many cases, laboratory professionals believe their salaries should be consistent with their workload, education, certification and the minimum wage in their state.³ Hiring, retention, and staffing challenges were the second most common theme that resulted from the qualitative analysis, with 4.93% of respondents indicating that there are shortages due to these challenges.³ Respondents also commented on feeling a lack of appreciation from their peers and lack of recognition in the health care field in general, despite being highly qualified and being an important part of patient care, 4.19%. Several expressed the need for increased visibility of the profession and to raise public awareness, with some feeling unionization would help with advocating for the profession and raising the salaries, 3.34%. A number of participants from rural areas commented on low wages and the impact of staffing shortages contributing to early burnout. In addition, some respondents from urban areas noted that their wages are insufficient to meet the high cost of living; 2.16%.3

ASCP also conducted a Job Satisfaction, Well-Being, and Burnout Survey of Laboratory Professionals to evaluate these factors for the field and to provide recommendations on well-being promotion. In the report, laboratory professionals indicate that while job satisfaction is high and well-being is rated fair to good by most respondents, feelings of anxiety or worry about work, stress, and burnout is notable among laboratory professionals.⁴ Among the top contributing factors to job stress, burnout, and work-life balance are lack of adequate staffing and workload.⁴ Similar to findings from the Wage survey, respondents in this survey expressed a belief that they are not adequately compensated for the work that they do.⁴

With the arrival of the pandemic in 2020, laboratory professionals were put in a spotlight because of their important role in performing complex diagnostic tests for COVID-19 and the concerns they have during this unprecedented time.⁵ These concerns have recently been outlined in several news stories. An article in the New York Times, "'Nobody Sees Us’: Testing-Lab Workers Strain Under Demand", reported on the challenges the laboratory workforce shortages are imposing on laboratory professionals, which are even more evident during the pandemic. The author stated that, “Across the nation, testing teams are grappling with burnout, repetitive-stress injuries and an overwhelming sense of doom. As supply chains sputter and laboratories rush to keep pace with diagnostic demand, experts warn that the most severe shortage stymieing America’s capacity to test is not one that can be solved by a wider production line or a more efficient machine. It is a dearth of human power: the dwindling ranks in a field that much of the public does not know even exists.”⁶ Burnout pre-pandemic has been exacerbated during the pandemic.⁵ This affected not only the well-being of laboratory professionals, but also laboratory operations. Those who were contemplating retirement have decided to fast-track their departure, leaving the laboratories with less staff and laboratory professionals with a breadth of expertise.⁶

The ASCP 2018 Vacancy Survey continues to argue that the laboratory industry’s focus should be on filling upcoming vacancies which are now at their highest levels compared to previous recent survey reports.⁷ With retirement rates continuing to increase, the field faces mounting challenges affecting the recruitment of the next generation of laboratory personnel. To alleviate these staffing shortages, the report urged the need for increasing laboratory personnel salaries at the local and national levels when developing their recruitment and retention strategies. ASCP also recognized through its wellness studies that pay not commensurate with experience and length of time contributes to burnout. Higher compensation, better benefits and flexibility are key topics that the field should target especially at this time.

These workforce reports and news articles have demonstrated the importance and value of laboratory professionals in the U.S. healthcare system and the world. While the ASCP wage report shows that salaries have increased overall, it still is discouraging to see that some laboratory professionals did not receive wage increases. That said, ASCP has heard of anecdotal reports that wages have further increased during the pandemic as clinical laboratories prioritized the recruiting and retention of qualified laboratory professionals. Now, more than ever, the pathology and laboratory community needs to come together to promote workforce advocacy. The increased profile of the laboratory profession brought about by the COVID-19 pandemic hopefully increases the door for lasting meaningful changes, such as increased wages and improved recognition of the contributions of laboratory professionals, that will brighten the future of this critically important healthcare profession.

The ASCP Leadership Institute and Institute for Science, Technology and Policy has created a Negotiation Toolkit to provide laboratory personnel recommendations on how to negotiate salaries that appropriate recognize their value to patient care.⁸ In addition, ASCP has created a resource website to support laboratory professionals better manage issues of stress and burnout. This resource includes the especially helpful and newly published Burnout Course offered for free to individuals in the field.^9,10

References

1. Clinical Laboratory Technologists and Technicians. bls.gov. https://www.bls.gov/ooh/healthcare/clinical-laboratory-technologists-and-technicians.htm. Published 2020. Accessed December 11, 2020.
2. XIFIN Lab Volume Index. XIFIN. https://www.xifin.com/resources/lab-volume-index?utm_medium=cpc&utm_source=google&utm_campaign=OU-lead-gen_7861874835%5bsearch%5d&utm_content=485698909400_c_&utm_term=xifin&gclid=Cj0KCQiAzsz-BRCCARIsANotFgOuh4Cuik5ZYuFG-ag_cXlBd6M_UIZsChmieFl8RDHyp-GNYDbWragaAjTNEALw_wcB&restored=1607702535641&restored=1607702670428. Published 2020. Accessed December 11, 2020.
3. Garcia E, Kundu I, Fong K. American Society for Clinical Pathology’s 2019 Wage Survey of Medical Laboratories in the United States [published online ahead of print, 2020 Nov 18]. Am J Clin Pathol. 2020;aqaa197. doi:10.1093/ajcp/aqaa197
4. Garcia E, Kundu I, Kelly M, Soles R, Mulder L, Talmon GA. The American Society for Clinical Pathology’s Job Satisfaction, Well-Being, and Burnout Survey of Laboratory Professionals. Am J Clin Pathol. 2020 Mar 9;153(4):470-486. doi: 10.1093/ajcp/aqaa008. PMID: 32080719.
5. Garcia E, Kundu I. Effects of the COVID-19 pandemic on medical laboratory staffing. Crit Val. 2021;14(1):22-25.
6. Wu K. ‘Nobody Sees Us’: Testing-Lab Workers Strain Under Demand. Nytimes.com. https://www.nytimes.com/2020/12/03/health/coronavirus-testing-labs-workers.html?referringSource=articleShare. Published 2020. Accessed December 11, 2020.
7. Garcia E, Kundu I, Kelly M, Soles R. The American Society for Clinical Pathology’s 2018 Vacancy Survey of Medical Laboratories in the United States. Am J Clin Pathol. 2019;152(2):155-168. doi:10.1093/ajcp/aqz046
8. ASCP Negotiation Toolkit. Ascp.org. https://www.ascp.org/content/docs/default-source/get-involved-pdfs/istp_workforce/7_200546_ls_leadership-institute_negotiation-toolkit_flyer.pdf?sfvrsn=2. Published 2020. Accessed December 11, 2020.
9. Workforce Initiatives. Ascp.org. https://www.ascp.org/content/get-involved/institute-of-science-technology-policy/workforce-initiatives. Published 2020. Accessed December 11, 2020.
10. Leadership Institute: Burnout. Store.ascp.org. https://store.ascp.org/productlisting/productdetail?productid=124494054&_ ga=2.180366048.694835027.1603990866-617320008.1584107348. Published 2020. Accessed December 11, 2020.