CAP Slightly Shifts Position
I have long advocated personnel licensure for clinical laboratory professionals because I believe licensure protects our scope of practice as well as protects the public welfare.
If you think about the people who are licensed--barbers, drivers, attorneys and almost every healthcare professional--you will see it is important to ensure only "qualified" individuals practice a profession.
Organizations such as the American Society for Clinical Laboratory Science (ASCLS) have supported model personnel licensure bills in many states, almost always to the strong opposition of the College of American Pathologists (CAP).
The official reasoning for nonsupport of the CAP--sometimes joined by ASCP and state pathology associations (at the urging of CAP, usually) --is licensure would exacerbate the clinical personnel shortage.
Actually, every independent survey shows this not to be true. In fact, there is some evidence professionals would be more attracted to the profession and would not leave due to burnout--more pay, more prestige, a protected scope. Without licensure, unscrupulous employers can hire non-certified individuals and pay them less to work side by side with certified laboratorians. Talk about a morale buster for everyone!
In some states, other professionals have seized on the non-licensure of laboratorians, encroached on our scope without the unique body of knowledge laboratorians have. Pharmacists and dietitians often order lab tests; pharmacists perform glucose testing, pregnancy tests and so on in pharmacies. Some practice acts have been rewritten to expand other health professionals' scope (nurses, respiratory therapists, etc.) to include "order and/or perform laboratory testing." In California, pharmacists lobbied to be included on the list of those eligible to be clinical lab directors. Licensure would restrict or clarify such rights and help to protect both our profession and patients.
Recently CAP has revised its position on universal opposition to laboratory personnel licensure.
CAP will now support bills that:
- make it clear the pathologist-director is in charge of all laboratory personnel;
- do not create conflict between scope of practice of the pathologist and non-MD laboratorian. An added benefit is they can continue to bill for reviewing and overseeing procedures;
- allow on-the-job training as a route for becoming a clinical laboratorian; and
- ensure state laboratory licensure boards mirror CAP's position.
This is a step in the right direction, but is certainly not ideal. The CAP is all about protection of the scope of practice of the pathologist and protecting their economic welfare.
Pathologists feel others should not be allowed to encroach on their scope of practice and I certainly understand and support that desire. However, I think non-physician clinical laboratorians also deserve the same logic.