Megan Ledford is a Medical Laboratory Scientist at Parkview Health in Fort Wayne. She originally published this blog as a Facebook post on March 30, and it went viral.
I have been seeing many posts and media articles lamenting the fact that we are too far behind in COVID-19 testing from where we should be, and I felt perhaps it was a good time to give a little extra insight into this issue. I am a big fan of statistical perspective, so here are some important stats. Megan Ledford
I am a Medical Laboratory Scientist. MLS’s require an average of 5 years of college education. Yes, we all have degrees. Our wonderful MLT’s have associate’s degrees. We all have bachelor’s degrees, and many of us have master’s degrees, especially those of us with slightly different titles such as “Research Scientists,” “Medical Scientists,” etc. Some of us even have doctorates. Some of your doctors were even MLS’s at one time before going to medical school. We are required to master the following subjects for certification and licensure: hematology, immunology, urinalysis, microbiology, chemistry, parasitology, toxicology, blood banking and transfusion, and lab safety and operation.
When you go to your doctor and are diagnosed with chronic lymphoid leukemia, there was an MLS behind a microscope who noticed irregular cells in your blood. When your doctor calls to let you know that you have low thyroid functioning, there was an MLS behind an analyzer and a graph who made the initial call that your tests did not fit the standard ranges. When an RN hangs antibiotics for a severe urinary tract infection, there was an MLS behind a media plate who determined which bacteria was responsible and which antibiotics would be most useful for your treatment.
People in this profession determine normal ranges of thousands of tests, the specimen requirements, ensure that all analyzers are operating at the perfect levels to ensure all results are accurate every single day. We design new procedures for testing and learn how to master dozens of different software programs simultaneously for every piece of instrumentation and test that is performed. Our work is both automated and also, largely, manual. And in the midst of everything we are responsible for, we also understand what the test results mean for your health and call the people who will be directly responsible for your diagnosis and treatment.
In the United States right now, there are approximately 310,000 laboratory professionals employed. There are 2.89 million nurses employed. There are 1.2 million doctors. In the US, there are approximately 350 million citizens. For laboratory professionals who take the brunt of all tests, that leaves 1,129 people per one laboratory scientist, and one person averages 39 various tests per year, which culminates in 14 billion tests.
Right now, in this pandemic, we are at a shortage for testing supplies. This is something many media sources are reporting daily, leading us all to believe that the biggest hindrance to testing volume in the US directly hinges on the availability of testing supplies. But this is not the only hindrance, and perhaps it is time to shine light on another hidden shortcoming in this country.
We are at a severe shortage of testing professionals, and we have been for many years. Our profession is one that tends to hide in the background despite our integral roles in disease research, patient care, treatment, and diagnoses, and this is because we tend to be the introverts or the nerds of healthcare, and we like it this way. Most other healthcare professionals don’t even realize we require five to seven years of college education.
Last week, in a six-day period, the US performed 335,000 COVID-19/SARS2 tests. At the time, there were 62 labs capable of performing this testing. Each test takes approximately 15 minutes of hands-on time, and these 62 labs employ approximately 1,600 lab scientists. This means 83,750 hours of testing occurred across 1,600 people. To accomplish this, each scientist would have required 52 hours to accomplish this volume on top of all the other testing that is required on a normal basis (since I think we all realize other diseases don’t stop due to a single viral outbreak). And this is all assuming none of these professionals get sick.
We are at a severe shortage of testing supplies, yes. But for too many years now, we have also been at a critical shortage of the only professionals capable and trained to run these tests for the third-largest population in the world.
I am not looking for praise or words of acknowledgment. I love my job without the recognition. I am only trying to raise awareness for a profession that tends to be overlooked when people think of “healthcare.”
This is not the first disease that has taken over, and it won’t be the last, and the brunt of forward movement falls on a group of people who are responsible for 1,129 people each. There is no one else on Earth who has the same amount of technical experience, nor the ability to run the tests and understand the results like we do.
It’s time we start telling our kids and our friends about the hidden side of healthcare so we can be better equipped in the future. The strain and the stress is overwhelming for many labs in our country, and they are doing an unbelievable job, as are the faces at the front of this pandemic—our nurses, doctors, RT’s, phlebotomists, EMT’s, EVS, and many others. We are also very lucky to have MLT’s and lab assistants in our ranks to work alongside us in the lab. We are all working hard, and we are all in this fight together.
Perhaps when we say, “The testing is not good enough,” we should also say, “But we are doing our best.”
Because we are.
If you are an introvert or technically minded or maybe if you are an extrovert who just loves the bare bones of the science behind the medicine... if you want to make a difference in the lives of others, consider laboratory science. We need you—especially for hard times like these.
Statistics for worker volume from the US Bureau of Labor 2019. Testing volume from the COVID test tracking site, CDC, and Johns Hopkins.
NOTE: Parkview Health does not do COVID-19 testing in-house. It is sending samples to state or commercial labs. Please refer to this Q&A on COVID-19 testing for details.