A New Year, New Decade, New Challenges
2010 is on the horizon; the dawn of a new year and a new decade. It's natural to reminisce about what has transpired these past few years and what to expect-or hope for- in 2010 and beyond. I have some suggestions.
Reminisce. Think back on how far we have come. Think how much science and technology have changed. Instead of all day enzyme assays performed on entire tubes of blood, we now use micro samples and random access analyzers that generate results in minutes.
As we express dissatisfaction with the status quo, we tend to forget the path we have traveled and how pivotal we have always been in ensuring quality healthcare.
As I wrote in a 2004 article for ADVANCE magazine, "Equally important is the reminder that even ‘way back then' we played a pivotal role in the diagnosis and treatment of diseases. Today's laboratorians have many more tools at their disposal, they can accomplish a lot more, and in less time. But all this progress grew out of a proud and dignified past."
Aim for unity. We have a fractured profession with dueling personnel names and certifications. Most states have no licensure protecting our scope of practice and increasing our worth in the marketplace. " Strength in unity" is not just a slogan. We are more likely to show real progress, achieve more recognition, express ourselves with more clarity and nonequivocation if we unify. This should be the message we send to our professional organizations and to each other.
Keep Up. One of my mantras over the years has been that in order to serve patients well, to feel self-assured, and to speak with authority clinical laboratorians must keep up with technology and science. It's one thing to be able to "do" a new fangled test; but what's the principle? What does an abnormal result mean? What are the sources of interference?
We need to be major players in developing best laboratory practices. We should help to develop and explain testing algorithms. We must know what tests should reflex to others, and which tests should be automatically canceled because the primary or screening test suggests the ordered test is not indicated. We need to develop interpretive lab reports to help physicians make sense of "data overload."
As we continue to rely on pathologists, we must realize that they are finding it harder to keep up with clinical lab science-that's our role and we should embrace it and accept it.
Be prepared for health care reform. We are not sure what this will look like, but it is coming. We must all keep abreast of changes to know what will be required in terms of information technology, reimbursement and new tests designed to support wellness. What tests will only be reimbursed only once per patient per hospital stay? In what areas will the lab be vulnerable to Recovery Audit Contractors (RAC) audits looking for Medicare overpayments? Will we have an extra burden to screen test requests and to document results better?
Get involved. Equally as important as telling others what we do is advocating for a more visible, viable role in society and our institutions. It is disheartening to hear new clinical lab science graduates express regret at their choice of a profession. Much of that second-guessing comes from the disconnect between the idealism of the classroom and the reality of observing the limited roles assumed by laboratorians on a day-to-day basis. But some of it also stems from war-weary disenchanted laboratorians who loudly proclaim their misery to all.
Learn resilience. If there is one essential skill for all laboratorians, it is learning to roll with the punches, to adapt to changes and bounce back from temporary setbacks. The sorts of challenges we faced in the last decade will not go away and might increase. So, we must learn to cope-or perish. Luckily resilience is a skill that can be learned like any other; and laboratorians are quick learners.
Hang on for a myriad of changes. 2010 and the new decade promises healthcare reform, new technology (like increased molecular testing), wellness testing, information technology reform, government mandates, decreased reimbursement, continuing personnel shortage, need for adoption of best practices, increased consultation with laboratorians by clinicians, an aging population requiring more testing, and an aging workforce contributing to unique scheduling issues.
As I thank and salute you, my colleagues, for all you have done this past decade (and the years before); I urge you to rise to the challenge of the next decade because it's going to be a bumpy, but exhilarating, ride.